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Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis

Ruyi Cai1,2,3,4, Jinshi Zhang1,2,3,4, Yifan Zhu2,3,4

  • 1School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, 310018, People's Republic of China.

International Urology and Nephrology
|January 3, 2021
PubMed

Insights

Patients with chronic kidney disease (CKD) infected with coronavirus disease 2019 (COVID-19) face a significantly higher mortality risk. This risk is particularly pronounced in younger CKD patients, underscoring the need for specialized care.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic has led to increased mortality globally.
  • Chronic kidney disease (CKD) is a prevalent condition, but its impact on COVID-19 mortality was not well-established.
  • A comprehensive summary of mortality risk in COVID-19 patients with CKD was lacking.

Purpose of the Study:

  • To determine the mortality frequency in patients with chronic kidney disease (CKD) who contract coronavirus disease 2019 (COVID-19).
  • To analyze the mortality risk associated with COVID-19 in CKD patients through a systematic literature review and meta-analysis.

Main Methods:

  • A systematic literature search was performed on PubMed, Embase, and Cochrane databases for studies published up to May 15, 2020.
  • Study quality was evaluated using a modified Newcastle-Ottawa Scale.
  • A meta-analysis was conducted on data from 12 selected studies, encompassing 3,867,367 patients, with subgroup analysis based on age.

Main Results:

  • COVID-19 patients with chronic kidney disease (CKD) exhibited a significantly higher mortality rate compared to CKD patients without COVID-19 (pooled OR = 5.81).
  • Subgroup analysis indicated a higher mortality rate in CKD patients with COVID-19 infection who were younger than 70 years (OR = 8.69) compared to those aged 70 and above (OR = 2.44).
  • The overall mortality rate in COVID-19 patients with CKD was substantial, with statistical significance (P < 0.00001).

Conclusions:

  • COVID-19 patients with chronic kidney disease (CKD) face a considerably elevated risk of mortality.
  • Younger CKD patients (<70 years) with COVID-19 infection demonstrated a particularly high mortality risk.
  • A comprehensive, multidisciplinary management strategy is essential for COVID-19 patients with CKD.

Keywords:
COVID-19Chronic kidney diseaseMortalitySARS-CoV-2

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