Risk Factors for Acute Kidney Injury in COVID-19 Patients: A Systematic Review

Abstract

BACKGROUND: Acute kidney injury (AKI) in coronavirus disease-19 (COVID-19) has high incidence and mortality. Risk factors for AKI in COVID-19 patients are not well explored. This systematic review provides a combination of available evidence regarding risk factors of AKI in COVID-19 patients. METHODS: A systematic research was performed in Medline, Cochrane Central Register of Controlled Trials, and ScienceDirect journal databases from 2019 to August 2020. The study selection process was plotted using a Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. RESULTS: Out of 553 studies found, four full-text studies met the inclusion criteria and were included in qualitative analysis. There are 2205 COVID-19 patients with AKI (36.44%) from 6051 COVID-19 patients. Age was a risk factors for AKI in two studies (odds ratio [OR] 1.03 [p < 0.001], OR 1.03 [p < 0.007]). Critical condition of patient is risk factors for AKI (OR 8.155 [p = 0.006]). Hirsch et al. stated that diabetes mellitus (OR 1.74 [p < 0.001]), cardiovascular disease (OR 1.48 [p < 0.001]), and hypertension (OR 1.25 [p = 0.02]) are also risk factors. Laboratory results such as elevated procalcitonin (PCT) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 showed positive association to AKI in COVID-19 patients (OR 4.822 [p = 0.037]; OR 13.451 [p = 0.016]). A higher sequential organ failure assessment (SOFA) score at admission is one of the risk factors (OR 1.498 [p = 0.027]). CONCLUSION: Demographics, clinical classification of COVID-19, comorbidities, SOFA score, PCT, and eGFR can help clinicians predict AKI in COVID-19 patients.

Incidence of, and Risk Factors and Outcomes Associated with, Acute Kidney Injury in COVID-19 at the National Kidney and Transplant Institute, Philippines

“…Looking at the inflammatory markers, univariable analysis found that LDH ( p < 0.001), hsCRP ( p = 0.001), and AST( p = 0.001) increased the odds of in-hospital mortality, while albumin decreased it ( p = 0.011). These results were comparable to the meta-analyses of Cai et al (2021) [ 10 ] and Daniella et al (2021) [ 11 ].…”

“…This study emphasized the high incidence of AKI in a CKD population (77%), compared to patients with undiagnosed CKD but with low baseline eGFR (39%) and those with normal eGFR (8%). The meta-analyses of Cai et al (2021) [ 10 ] and Daniella et al (2021) [ 11 ] both showed that underlying CKD was strongly associated with AKI. Damage to viable nephrons leads to a reduction in renal functional reserve, predisposing to AKI.…”

“…AKI is increasingly being recognized as a negative prognostic factor in patients with COVID-19 due to its high incidence (19.76%) and mortality rate (54.24%) [ 11 ]. The occurrence of AKI was independently associated with increased mortality at 30 days post-admission, with a notably higher risk with increasing severity [ 12 ].…”

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

“…It is pertinent to mention that the reviews reporting the lowest (23,26,39) and highest (28, 35,42,45,46) incidence of CAKI did not explain the reasons for such variations. However, the disease severity was reported as the most common contributor to the variable incidence of CAKI among COVID-19 patients.…”

Pengaruh Pemberian Alpha Lipoic Acid terhadap Perbaikan Derajat Distal Symetrical Diabetic Polineurophaty

“…Dalam studi yang dilakukan oleh Daniella (2021) ditemukan bahwa tiap peningkatan 1% kadar HbA1C akan meningkatkan risiko mengalami neuropati diabetik sebesar 2.8 kali lipat. Semakin lama seseorang menderita DM, proses tersebut akan berlangsung lebih lama dan pada akhirnya semakin merusak sel saraf (15). Hal tersebut dibuktikan dalam penelitian Lee (2015) yang menemukan bahwa prevalensi neuropathy diabetik pada pasien dengan DM < 5 tahun sebesar 20,8% dan pada DM >10 tahun sebesar 36,8% (16).…”