TY - JOUR T1 - High burden of acute kidney injury in COVID-19 pandemic: systematic review and meta-analysis JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 796 LP - 803 DO - 10.1136/jclinpath-2020-207023 VL - 74 IS - 12 AU - Camila Barbosa Oliveira AU - Camilla Albertina Dantas Lima AU - Gisele Vajgel AU - Antonio Victor Campos Coelho AU - Paula Sandrin-Garcia Y1 - 2021/12/01 UR - http://jcp.bmj.com/content/74/12/796.abstract N2 - Aims Hospitalised patients with COVID-19 have a variable incidence of acute kidney injury (AKI) according to studies from different nationalities. The present systematic review and meta-analysis describes the incidence of AKI, need for renal replacement therapy (RRT) and mortality among patients with COVID-19-associated AKI.Methods We systematically searched electronic database PubMed, SCOPUS and Web of Science to identify English articles published until 25 May 2020. In case of significant heterogeneity, the meta-analyses were conducted assuming a random-effects model.Results From 746 screened publications, we selected 21 observational studies with 15 536 patients with COVID-19 for random-effects model meta-analyses. The overall incidence of AKI was 12.3% (95% CI 7.3% to 20.0%) and 77% of patients with AKI were critically ill (95% CI 58.9% to 89.0%). The mortality among patients with AKI was 67% (95% CI 39.8% to 86.2%) and the risk of death was 13 times higher compared with patients without AKI (OR=13.3; 95% CI 6.1 to 29.2). Patients with COVID-19-associated AKI needed for RRT in 23.4% of cases (95% CI 12.6% to 39.4%) and those cases had high mortality (89%–100%).Conclusion The present study evidenced an incidence of COVID-19-associated AKI higher than previous meta-analysis. The majority of patients affected by AKI were critically ill and mortality rate among AKI cases was high. Thus, it is extremely important for health systems to be aware about the impact of AKI on patients’ outcomes in order to establish proper screening, prevention of additional damage to the kidneys and adequate renal support when needed.All data relevant to the study are included in the article. ER -