PREVALENCE OF ACUTE KIDNEY INJURY THROUGHOUT COVID-19: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introduction:

Acute Kidney Injury (AKI) is a common complication of COVID in hospitalised patients. Reported AKI prevalence at the beginning of COVID was high, whereas a lower AKI prevalence was observed towards later waves of COVID. This systematic review and meta-analysis aim to evaluate the temporal trends in AKI prevalence among COVID patients throughout the pandemic.

Methods:

We systematically searched PubMed, Embase, Scopus, Web of Science and Cochrane Library for full-text articles available in English published from January 2020 to November 2023. Observational, retrospective, prospective and longitudinal cohort studies that reported the number of COVID AKI patients were included. In total, 12 studies that reported multiple study periods and met the inclusion criteria were included in this systematic review and meta-analysis. The study periods covered from the beginning of COVID to November 2022. AKI was defined according to KDIGO criteria in all included studies. A random-effect model was employed due to the significant study heterogeneity. 

Results:

In total, 31,441 hospitalised COVID patients from both Intensive Care Unit and general ward were included in this meta-analysis from 12 studies. Of 12 studies, 6 were ICU-only cohorts. The pooled AKI prevalence among the ICU cohort was 0.43 [0.36; 0.52]. For studies that included general hospitalised patients, the pooled AKI prevalence was 0.15 [0.11; 0.18]. 31 study periods were reported, with 21 study periods starting in 2020, 9 study periods starting in 2021, and 1 in 2022. Looking at the individual study timeline, 11 of 12 studies reported a lower AKI prevalence later in the COVID pandemic compared to the early stage of COVID. There were 10 studies that reported mortality, most reporting a lower mortality rate later in the COVID pandemic.

Figure 1: Acute Kidney Injury prevalence at each study period timeline  

Figure 2: mortality at each study period timeline 

Conclusions:

Our study has shown a temporal trend where COVID AKI prevalence was higher during the early stages of the COVID pandemic compared to later waves. The observed decline in AKI prevalence over time may suggest the advancement in treatment and patient management. Further research is required to explore the underlying mechanisms driving this decline in COVID AKI prevalence and to continue improving kidney health in future pandemic scenarios. 

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.
I used Grammarly for gramma check.