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

Tauqeer Hussain Mallhi; Yusra Habib Khan; Abdulaziz Ibrahim Alzarea; Faiz Ullah Khan; Nasser Hadal Alotaibi; Abdullah Salah Alanazi; Muhammad Hammad Butt; Ahmed D Alatawi; Muhammad Salman; Sami I Alzarea; Ziyad Saeed Almalki; Mansoor A Alghazi; Majed Ahmed Algarni

doi:10.3389/fmed.2022.973030

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

Front Med (Lausanne). 2022 Nov 4:9:973030. doi: 10.3389/fmed.2022.973030. eCollection 2022.

Authors

Affiliations

¹ Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia.
² Health Sciences Research Unit, Jouf University, Sakaka, Saudi Arabia.
³ Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
⁴ Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden.
⁵ Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan.
⁶ Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia.
⁷ Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
⁸ Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
⁹ Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia.

Abstract

The COVID-19 associated acute kidney injury (CAKI) has emerged as a potential intricacy during the management of patients. Navigating the rapidly growing body of scientific literature on CAKI is challenging, and ongoing critical appraisal of this complication is essential. This study aimed to summarize and critically appraise the systematic reviews (SRs) on CAKI to inform the healthcare providers about its prevalence, risk factors and outcomes. All the SRs were searched in major databases (PubMed, EMBASE, Web of Science) from inception date to December 2021. This study followed SR of SRs methodology, all the records were screened, extracted and subjected to quality assessment by assessing the methodological quality of systematic reviews (AMSTAR-2). The extracted data were qualitatively synthesized and tabulated. This review protocol was registered in PROSPERO (CRD42022299444). Of 3,833 records identified; 42 SRs were included in this overview. The quality appraisal of the studies showed that 17 SRs were of low quality, while 8 moderate and 17 were of high-quality SRs. The incidence of CAKI ranged from 4.3% to 36.4% in overall COVID-19 patients, 36%-50% in kidney transplant recipients (KTRs), and up to 53% in severe or critical illness. Old age, male gender, cardiovascular disease, chronic kidney disease, diabetes mellitus and hypertension were frequently reported risk factors of CAKI. The need of renal replacement therapy (RRT) was up to 26.4% in overall COVID-19 patients, and 39% among those having CAKI. The occurrence of acute kidney injury (AKI) was found independent predictor of death, where mortality rate among CAKI patients ranged from 50% to 93%. This overview of SRs underscores that CAKI occurs frequently among COVID-19 patients and associated with high mortality, need of RRT and adverse outcomes. However, the confidence of these results is moderate to low which warrants the need of more SRs having established methodological standards.

Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299444], identifier [CRD42022299444].

Keywords: COVID-19; SARS-CoV-2; acute kidney injury; complications; coronavirus; mortality; risk factors.

Publication types

Systematic Review