Acute kidney injury and its association with mortality in Asian COVID-19 patients: A meta-analysis

Clin Nephrol. 2022 Oct;98(4):188-197. doi: 10.5414/CN110899.

Abstract

Background: Previous evidence suggests that acute kidney injury (AKI) is common in patients with COVID-19 and associated with adverse outcomes. Moreover, the incidence and mortality of AKI in Asia are ambiguous.

Objective: Evaluating the risk factors and risk of death from AKI in -COVID-19 patients in Asia.

Materials and methods: We conducted a meta-analysis of clinical observational studies of -COVID-19 patients in Asia. Outcome measures included: AKI in COVID-19 patients, overall mortality in COVID-19 patients, and mortality assessment in patients with AKI. The random-effects model was adopted, with heterogeneity and sensitivity analysis.

Results: 27 clinical studies (18,216 Asian patients with COVID-19) have been included in the study. The pooled incidence of AKI was 0.19 (95% CI 16 - 23%; I2 = 98.9%, p < 0.001); the pooled incidence of total mortality was 0.19 (95% CI 17 - 22%; I2 = 98.9%, p < 0.001). No publication bias was found (Egger's test, p = 0.396, 0.213). The pooled mortality in AKI patients with COVID-19 was 50% (95% CI 33 - 67%; I2 by random-effects model = 98.4%, p < 0.001). AKI was found to be a risk factor for death in stepwise regression analysis; age, diabetes, and hypertension were influencing factors for AKI risk in -COVID-19 patients.

Conclusion: AKI is a common complication in Asian COVID-19 patients, and it is associated with an increase in mortality of Asian COVID-19 patients. Any treatment that protects the kidney may be a practical intervention to reduce the mortality of COVID-19 patients in Asia.

Publication types

  • Meta-Analysis

MeSH terms

  • Acute Kidney Injury* / etiology
  • Asia
  • COVID-19* / complications
  • Humans
  • Incidence
  • Risk Factors