Incidence, risk factors and outcomes of acute kidney injury among COVID-19 patients: A systematic review of systematic reviews

Abstract

The COVID-19 associated acute kidney injury (CAKI) has emerged as a potential intricacy during the management of patients. Navigating the rapidly growing body of scientific literature on CAKI is challenging, and ongoing critical appraisal of this complication is essential. This study aimed to summarize and critically appraise the systematic reviews (SRs) on CAKI to inform the healthcare providers about its prevalence, risk factors and outcomes. All the SRs were searched in major databases (PubMed, EMBASE, Web of Science) from inception date to December 2021. This study followed SR of SRs methodology, all the records were screened, extracted and subjected to quality assessment by assessing the methodological quality of systematic reviews (AMSTAR-2). The extracted data were qualitatively synthesized and tabulated. This review protocol was registered in PROSPERO (CRD42022299444). Of 3,833 records identified; 42 SRs were included in this overview. The quality appraisal of the studies showed that 17 SRs were of low quality, while 8 moderate and 17 were of high-quality SRs. The incidence of CAKI ranged from 4.3% to 36.4% in overall COVID-19 patients, 36%–50% in kidney transplant recipients (KTRs), and up to 53% in severe or critical illness. Old age, male gender, cardiovascular disease, chronic kidney disease, diabetes mellitus and hypertension were frequently reported risk factors of CAKI. The need of renal replacement therapy (RRT) was up to 26.4% in overall COVID-19 patients, and 39% among those having CAKI. The occurrence of acute kidney injury (AKI) was found independent predictor of death, where mortality rate among CAKI patients ranged from 50% to 93%. This overview of SRs underscores that CAKI occurs frequently among COVID-19 patients and associated with high mortality, need of RRT and adverse outcomes. However, the confidence of these results is moderate to low which warrants the need of more SRs having established methodological standards.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299444], identifier [CRD42022299444].

Outcomes, Healthcare Resource Utilization, and Costs of Overall, Community-Acquired, and Hospital-Acquired Acute Kidney Injury in COVID-19 Patients

“…11,23 Recent reviews and meta-analyses that include many studies of the early pandemic period reported the following ranges: 28% to 34% 11,14,15,40 prevalence of overall AKI, 46% to 77% prevalence of AKI in ICU patients, 11,14,40 and 2.55 to 23.09 for OR for mortality. 41 Furthermore, in a study of AKI in COVID patients during all of 2020, HR (95% CI) for mortality was 3.8 (3.24-4.45), and mean LOS was 10.4 days. 42 Among COVID patients admitted to UK hospitals in 2020, the adjusted OR (95% CI) for in-hospital mortality was 1.91 (1.82-2.01) for biochemically determined AKI (vs no AKI), 2.41 (2.20-2.64) for stage 2 AKI, and 3.50 (3.14-3.91) for stage 3 AKI.…”

Temporal validation of the MMCD score to predict kidney replacement therapy and in-hospital mortality in COVID-19 patients

“…Many of these patients require KRT, increasing the resources needed for care and evolving greater morbidity and mortality. Measures to prevent the occurrence or progression to a more severe progression of AKI are fundamental [ 26 , 27 ]. Thus, early prognostic assessment and risk stratification measures that support clinical decisions in allocating appropriate resources and early interventions to each patient have the potential to enhance personalized hospital care and to help reduce morbidity and mortality rates [ 28 ].…”

Atypical Complications during the Course of COVID-19: A Comprehensive Review

“…Previously, there have been a few reviews on extrapulmonary manifestations [8,[10][11][12][13], but the types of complications and their overall effect on hospitalization and mortality rates have never been explored. In addition, a large number of reviews exist on manifestations in individual organ systems of the body [14][15][16][17][18][19], but no study has ever attempted to gather information in a single article through extensive research on major organ systems. Furthermore, there are other infections that can cause atypical complications, i.e., dengue and Varicella-Zoster virus infections are well known to cause dementia, chronic encephalitis, aseptic meningitis, multiple sclerosis, acute pancreatitis, and myopericarditis [20][21][22][23][24][25] and such complications further accelerate patient hospitalization and rates of morbidity and mortality, which, in turn, render a huge burden on the healthcare system.…”