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Risk Factors and Clinical Characteristics of Acute Kidney Injury in Patients with COVID-19: A Systematic Review and

Amal Arifi Hidayat1, Vania Azalia Gunawan1, Firda Rachmawati Iragama1

  • 1Internal Medicine Resident, Department of Internal Medicine, Dr. Soetomo Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.

Pathophysiology : the Official Journal of the International Society for Pathophysiology
|May 23, 2023
PubMed

Insights

Identifying acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients is crucial. Male gender, diabetes, hypertension, and pre-existing conditions like chronic kidney disease increase AKI risk in COVID-19 patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a significant complication in patients with coronavirus disease 2019 (COVID-19), often leading to poorer outcomes.
  • Early identification and understanding of AKI risk factors in COVID-19 are essential for timely intervention and improved patient management.

Purpose of the Study:

  • To systematically identify and analyze the risk factors and comorbidities associated with the development of AKI in patients diagnosed with COVID-19.
  • To compare the prevalence of various risk factors and comorbidities between COVID-19 patients who developed AKI and those who did not.

Main Methods:

  • A systematic literature search was conducted using PubMed and DOAJ databases.
  • Studies included confirmed COVID-19 patients with available data on AKI risk factors and comorbidities.
  • Data from 30 studies encompassing 22,385 patients were analyzed, comparing AKI and non-AKI cohorts.

Main Results:

  • Male gender, diabetes, hypertension, ischemic cardiac disease, heart failure, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), peripheral vascular disease, and NSAID use were significant independent risk factors for AKI in COVID-19 patients.
  • Patients with AKI exhibited higher rates of proteinuria, hematuria, and invasive mechanical ventilation.
  • Odds ratios indicated significant associations for all identified risk factors and clinical presentations.

Conclusions:

  • Several comorbidities and demographic factors, including male gender, diabetes, hypertension, cardiovascular diseases, CKD, COPD, peripheral vascular disease, and NSAID use, are independently associated with an increased risk of AKI in COVID-19 patients.
  • The presence of proteinuria, hematuria, and the need for mechanical ventilation are indicators of AKI in the context of COVID-19.
  • These findings underscore the importance of monitoring kidney function in high-risk COVID-19 patients and managing associated comorbidities.

Keywords:
2019-nCoV diseaseCOVID-19SARS-CoV-2 infectionacute kidney injury

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