Kidney disease and COVID-19 disease severity—systematic review and meta-analysis

Jagmeet Singh, Preeti Malik, Nidhi Patel, Suveenkrishna Pothuru, Avantika Israni, Raja Chandra Chakinala, Maryam Rafaqat Hussain, Anusha Chidharla, Harshil Patel, Saurabh Kumar Patel, Rizwan Rabbani, Urvish Patel, Savneek Chugh, Asim Kichloo

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

We aimed to identify prevalence and association of comorbid chronic kidney disease (CKD), acute kidney injury (AKI) and utilization prevalence of continuous renal replacement therapy (CRRT) in COVID-19-hospitalized patients as a function of severity status. With the ongoing struggle across the globe to combat COVID-19 disease, published literature has described the role of kidney disease in COVID-19 patients based on single/multicenter experiences across the globe. We extracted data from observational studies describing comorbid CKD, AKI and CRRT and outcomes and severity of COVID-19-hospitalized patients from December 1, 2019–August 20, 2020 following PRISMA guidelines. Severity of COVID-19 includes intensive care unit admission, oxygen saturation < 90%, invasive mechanical ventilation utilization, in-hospital admission and mortality. Meta-analysis was performed using a random-effects model to calculate pooled estimates, and forest plots were created. In total, 29 studies with 15,017 confirmed COVID-19 patients were included. The overall prevalence of AKI was 11.6% [(430/3693)], comorbid CKD 9.7% [(1342/13,728)] and CRRT 2.58% [(102/3946)] in our meta-analysis. We also found higher odds of comorbid CKD (pooled OR: 1.70; 95%CI: 1.21–2.40; p = 0.002), AKI (8.28; 4.42–15.52; p < 0.00001) and utilization of CRRT (16.90; 9.00–31.74; p < 0.00001) in patients with severe COVID-19 disease. Conclusion Our meta-analysis suggests that comorbid CKD, AKI and utilization of CRRT were significantly associated with COVID-19 disease severity. Clinicians should focus on early triaging of COVID-19 patients with comorbid CKD and at risk for AKI to prevent complication and mortality.

Original languageEnglish
Pages (from-to)125-135
Number of pages11
JournalClinical and Experimental Medicine
Volume22
Issue number1
DOIs
StatePublished - Feb 2022

Keywords

  • COVID-19
  • Chronic kidney disease
  • Continuous renal replacement therapy
  • Coronavirus
  • Kidney disease
  • Kidney injury

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