Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis

PURPOSE: Reported rates of acute kidney injury (AKI) have varied significantly among studies of coronavirus disease 2019 (COVID-19) published to date. The present meta-analysis was conducted to gain clarity regarding AKI incidence and renal replacement therapy (RRT) use in COVID-19 patients. METHODS: The PubMed, Embase, Web of Science, medRxiv, and bioRxiv databases were systematically searched for COVID-19-related case reports published through 25 July 2020. Pooled analyses were conducted using R. RESULTS: The pooled incidence of AKI in 51 studies including 21,531 patients was 12.3% (95% CI 9.5–15.6%), with higher rates of 38.9% in 290 transplant patients (95% CI 27.3–51.9%), 39.0% in 565 ICU patients (95% CI 23.2–57.6%) and 42.0% among 1745 deceased patients (95% CI 30.3–54.7%). RRT usage was reported in 39 studies of 17,664 patients, with an overall pooled use of 5.4% (95% CI 4.0–7.1%), with higher rates of 15.6% in 117 transplant patients (95%CI 9.9–23.8%) and 16.3% in 776 ICU patients (95% CI 11.1–23.3%). CONCLUSION: AKI and RRT use among COVID-19 patients represent a major public health concern, and early and appropriate intervention should be called upon to improve the prognosis of patients suffering from AKI.