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Ann Med
. 2020 Jul 8;1-18.
doi: 10.1080/07853890.2020.1790643. Online ahead of print.
Renal Complications in COVID-19: A Systematic Review and Meta-Analysis
Setor K Kunutsor 1 2 , Jari A Laukkanen 3 4 5
Affiliations
- PMID: 32643418
- DOI: 10.1080/07853890.2020.1790643
Abstract
Purpose: Emerging data suggests coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluaterenal complications of COVID-19 and their incidence using a systematic meta-analysis.Design: Observational studies reporting renal complications in COVID-19 patients were sought from MEDLINE, Embase and the Cochrane Libraryfrom 2019 to June 2020. The nine-star Newcastle-Ottawa Scale was used to evaluate methodological quality.Incidence with 95% confidence intervals (CIs) were pooled using random-effects models.Results: We included 22observational cohort studies comprising of 17,391COVID-19 patients. Quality scores of studies ranged from 4-6.The pooled prevalence of pre-existing chronic kidney disease (CKD) and end-stage kidney disease was5.2% (2.8-8.1)and 2.3% (1.8-2.8) respectively. The pooled incidence over follow-up of 2-28 days was 12.5% (10.1-15.0) forelectrolyte disturbance (eg, hyperkalaemia), 11.0% (7.4-15.1) foracute kidney injury (AKI) and 6.8% (1.0-17.0) for renal replacement therapy (RRT).In subgroup analyses, there was a higher incidence of AKI inUS populations andgroups with higher prevalence of pre-existing CKD.Conclusions: Frequent renal complicationsreported among hospitalised COVID-19 patientsare electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes.Systematic review registration: PROSPERO 2020: CRD42020186873 Key messagesCOVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined.In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was5.2%.The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia)with an incidence of 12.5% followed by acute kidney injury (AKI)with an incidence of 11.0%;US populations andgroups with higher prevalence of CKD had higher incidence of AKI.
Keywords: COVID-19; acute kidney injury; meta-analysis; renal complications.