Background: coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome—coronavirus-2 (SARS-CoV-2)—is an ongoing pandemic with high morbidity and mortality rates. Preliminary evidence suggests that acute kidney injury (AKI) is uncommon in patients with COVID-19 and associated with poor outcomes. Study aims and design: we performed a systematic review of the literature with a meta-analysis of clinical studies to evaluate the frequency of AKI and dialysis requirement in patients who underwent hospitalization due to COVID-19. The incidence of AKI according to the death risk was calculated in these patients. The random-effects model of DerSimonian and Laird was adopted, with heterogeneity and stratified analyses. Results: thirty-nine clinical studies (n = 25,566 unique patients) were retrieved. The pooled incidence of AKI was 0.154 (95% CI, 0.107; 0.201; p < 0.0001) across the studies. Significant heterogeneity was found ( p = 0.0001). The overall frequency of COVID-19-positive patients who underwent renal replacement therapy (RRT) was 0.043 (95% CI, 0.031; 0.055; p < 0.0001); no publication bias was found (Egger’s test, p = 0.11). The pooled estimate of AKI incidence in patients with severe COVID-19 was 0.53 (95% CI, 0.427; 0.633) and heterogeneity occurred (Q = 621.08, I2 = 97.26, p = 0.0001). According to our meta-regression, age ( p < 0.007) and arterial hypertension ( p < 0.001) were associated with AKI occurrence in hospitalized COVID-19 positive patients. The odds ratio (OR) for the incidence of AKI in deceased COVID-19 positive patients was greater than among survivors, 15.4 (95% CI, 20.99; 11.4; p < 0.001). Conclusions: AKI is a common complication in hospitalized COVID-19 positive patients. Additional studies are under way to assess the risk of AKI in COVID-19 patients and to deepen the mechanisms of kidney injury.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Acute kidney injury, renal replacement therapy, severe disease, 【초록키워드】 coronavirus disease, Meta-analysis, pandemic, severe COVID-19, Hospitalization, systematic review, risk, heterogeneity, meta-regression, dialysis, Kidney injury, outcomes, AKI, Survivors, Patient, death, age, morbidity and mortality, incidence, patients, mechanism, clinical study, Frequency, Deceased, Odds ratio, COVID-19 patient, Arterial hypertension, RRT, 95% CI, positive patients, random-effects model, preliminary evidence, hospitalized COVID-19, Occurrence, greater, performed, evaluate, occurred, caused, calculated, unique, adopted, analyses, Significant, stratified, COVID-19 positive patient, Egger’s test, patients with COVID-19, retrieved, 【제목키워드】 review,