Risk Factors for Acute Kidney Injury in Patients with Coronavirus Disease 2019 (COVID-19): A Meta-Analysis

Abstract

BackgroundAcute kidney injury (AKI) frequently develops in patients with Coronavirus Disease 2019 and is associated with poor outcome. Unfortunately, risk factors for AKI in COVID-19 have not been clearly elucidated. Clinical evidence is required to identify risk factors for AKI and to adopt appropriate management strategies during early COVID-19 intervention.MethodThe PubMed, MEDLINE, Web of Science, EMBASE, Google Scholar, Scopus, and Elsevier Science direct were systematically searched up to September 2020. The studies that reported risk factors for AKI in patients with COVID-19 were included. Statistical analysis was performed using Review Manager Software (RevMan 5.3). Pool odds ratio (OR) with 95% confidence interval (CI) were assessed for each risk factor.ResultsEleven studies with 8815 COCID-19 patients fulfilled eligibility criteria were incorporated into the meta-analysis, and sixteen risk factors related to AKI in patients with COVID-19 were included and analyzed. The following variables probably correlated with an increased risk of AKI in COVID-19 patients: male (OR=1.62, 95% CI, 1.24-2.13, P<0.05), mechanical ventilation (OR=9.44, 95% CI, 5.16-17.27, P<0.05), ICU admission (OR=10.57, 95%CI, 9.33-11.98, P<0.00001), use of vasopressor (OR=19.36, 95%CI, 16.77-22.34, P<0.00001), obesity (OR =1.75 ,95%CI, 1.58-1.95, p<0.00001), diabetes (OR= 1.73, 95% CI, 1.57-1.90, p<0.00001), hypertension (OR=1.53 , 95% CI, 1.04-2.20, p=0.03), cardiac disease (OR = 1.71, 95% CI, 1.51-1.94, p<0.00001), CKD (OR=2.86, 95%CI, 1.54-5.32, p=0.0009), and COPD (OR= 1.7 ,95% CI, 1.40-2.07, p<0.00001). The factors RAAS inhibitors use, cerebrovascular disease and malignancy were not significantly associated with AKI in patients with COVID-19.ConclusionsOur meta-analysis revealed a variety of risk factors for AKI in patients with COVID-19. There findings strengthened clinical awareness of early warning to identify COVID-19 patients with high risk for AKI.

Acute kidney injury in patients with COVID-19: Epidemiology, pathogenesis and treatment

“…31 In the previously cited meta-analyses by Fu et al, Lin et 3). 16,24,25,34 Factors with the most important impact on the risk of acute kidney injury in the course of COVID-19 were those related to the severity of a patient's condition, i.e., the need to use catecholamines infusion (in the course of septic shock), and the need to use artificial ventilation (due to respiratory failure). 23,24,31…”