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Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis.
BMJ Open. 2020 11 10; 10(11):e042573.BO

Abstract

OBJECTIVE

To analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19.

DESIGN

Meta-analysis.

DATA SOURCES

PubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020.

STUDY SELECTION

Studies examining the following demographics and outcomes were included: patients' age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection.

RESULTS

A total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92-4.25) and an OR of 6.07, 95% CI (2.53-14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83-15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13-13.36).

CONCLUSION

AKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI.

Authors+Show Affiliations

Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Ultrasound, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Nephrology, Jiulongpo People's Hospital of Chongqing, Chongqing, China.Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China 650230@hospital.cqmu.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33172950

Citation

Lin, Lirong, et al. "Risk Factors and Prognosis for COVID-19-induced Acute Kidney Injury: a Meta-analysis." BMJ Open, vol. 10, no. 11, 2020, pp. e042573.
Lin L, Wang X, Ren J, et al. Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis. BMJ Open. 2020;10(11):e042573.
Lin, L., Wang, X., Ren, J., Sun, Y., Yu, R., Li, K., Zheng, L., & Yang, J. (2020). Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis. BMJ Open, 10(11), e042573. https://doi.org/10.1136/bmjopen-2020-042573
Lin L, et al. Risk Factors and Prognosis for COVID-19-induced Acute Kidney Injury: a Meta-analysis. BMJ Open. 2020 11 10;10(11):e042573. PubMed PMID: 33172950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis. AU - Lin,Lirong, AU - Wang,Xiang, AU - Ren,Jiangwen, AU - Sun,Yan, AU - Yu,Rongjie, AU - Li,Kailong, AU - Zheng,Luquan, AU - Yang,Jurong, Y1 - 2020/11/10/ PY - 2020/11/11/entrez PY - 2020/11/12/pubmed PY - 2020/11/20/medline KW - acute renal failure KW - kidney & urinary tract disorders KW - nephrology SP - e042573 EP - e042573 JF - BMJ open JO - BMJ Open VL - 10 IS - 11 N2 - OBJECTIVE: To analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19. DESIGN: Meta-analysis. DATA SOURCES: PubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020. STUDY SELECTION: Studies examining the following demographics and outcomes were included: patients' age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection. RESULTS: A total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92-4.25) and an OR of 6.07, 95% CI (2.53-14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83-15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13-13.36). CONCLUSION: AKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/33172950/Risk_factors_and_prognosis_for_COVID_19_induced_acute_kidney_injury:_a_meta_analysis_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=33172950 DB - PRIME DP - Unbound Medicine ER -