AKI during COVID-19 infection: low incidence, high risk of death

AbstractBackgroundCoronavirus disease 2019 (COVID-19) has spread rapidly worldwide and seriously threatens human health since December 2019. However, information about acute kidney injury (AKI) during COVID-19 infection is limited. Some studies thought that presence of AKI is very common and cannot be ignored, while some studies pointed that AKI only is a rare incident during COVID-19 infection. This meta-analysis aimed to find out the truth of COVID-19 related AKI and to provide stronger evidence.MethodsTwo authors independently performed a literature search using PubMed, Web of Science, Embase, and Cochrane Library fulfilled the pre-specified criteria until April 25, 2020 to include studies reported the necessary clinic characteristics, then the incidence of AKI, incidence of required RRT, the mortality with AKI and the death risk with AKI during COVID-19 infection were pooled for statistical analysis by Open Meta-Analyst software to get conclusions.FindingsIt was found that the incidence of AKI in hospitalized patients with COVID-19 infection is low, only about 3.8%; the in-hospital mortality with AKI in COVID-19 infected patients is reach up to 32.6%; the death risk with AKI in COVID-19 infected patients is about 16.1 times higher than those without AKI.ConclusionsThis meta-analysis indicated AKI during COVID-19 infection should be pay more attention, it maybe a strong red flag to death risk. It is still need additional studies to support the conclusions and to explore the AKI mechanism during COVID-19 infection.

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Rates, predictors and mortality of sepsis-associated acute kidney injury: systematic review and meta-analysis

10.21203/rs.3.rs-18145/v3 ◽

2020 ◽

Author(s):

Jie feng Liu ◽

Hebin Xie ◽

ziwei ye ◽

Lesan Wang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Septic Shock ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Predisposing Factors ◽

Cochrane Library ◽

Patient Specific ◽

Cumulative Number

Abstract Objective:The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result: Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion: A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

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Complicações renais decorrentes da infecção por SARS-CoV-2 em pessoas com COVID-19 hospitalizadas: scoping review

Research Society and Development ◽

10.33448/rsd-v11i1.25217 ◽

2022 ◽

Vol 11 (1) ◽

pp. e40811125217

Author(s):

Anyele Albuquerque Lima ◽

Alda Graciele Claudio dos Santo Almeida ◽

Izabelly Carollynny Maciel Nunes ◽

Patrícia de Albuquerque Sarmento ◽

Wanda Tenório Barros Passos Alves

Keyword(s):

Acute Kidney Injury ◽

Scoping Review ◽

Web Of Science ◽

Kidney Diseases ◽

Grey Literature ◽

Kidney Injury ◽

Glomerular Disease ◽

Google Scholar ◽

Cochrane Library

Objetivos: Identificar complicações/sequelas renais decorrentes da infecção por SARS-CoV-2 em pessoas com COVID-19; e descrever a característica de idade da população estudada. Metodologia: Scoping Review realizada nas bases de dados Web of Science, BVS, Cochrane Library, MEDLINE/PubMed, CINAHL, SCOPUS, Embase, LILACS. E nos sites online: ProQuest Dissertations and Theses, Grey Literature e Google Scholar. Os descritores utilizados foram (comorbidity OR sequel OR complications), (kidney diseases OR glomerular disease OR acute kidney injury OR nephropathy) AND (coronavirus OR SARS-CoV-2 OR COVID-19). Critérios de inclusão: artigos em português, inglês e espanhol, com abordagens metodológicas diversas, disponíveis na íntegra, online, publicados no período de 01 de janeiro de 2020 a 29 de setembro de 2021. E de exclusão: pessoas com diagnósticos prévios de patologias renais agudas e/ou crônicas; cartas ao editor; artigos de opinião; editoriais; e notas. Resultados: Selecionaram-se 10 artigos, que evidenciaram que o processo infeccioso causado pelo SARS-CoV-2 pode iniciar com uma leve proteinúria e hematúria, e evoluir para uma injúria renal aguda causada pela diminuição da capacidade de filtração glomerular, que favorece a retenção de algumas escórias nitrogenadas, causando o aumento dos níveis de creatinina e de ureia. Ademais, informaram que indivíduos entre 52-69 anos foram os mais acometidos. Considerações finais: As complicações/sequelas renais decorrentes da infecção por SARS-CoV-2 são: deposição de imunocomplexos nas células renais, proteinúria, hematúria, aumento da creatinina sérica, aumento da ureia nitrogenada no sangue, diminuição da TFG, e IRA estágio 1, 2 e 3. Tais complicações ocorreram principalmente em pessoas com idade ≥ 52 anos.

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No Difference in Risk of Acute Kidney Injury Between Adult Patients Receiving Different Types of Extracorporeal Membrane Oxygenation

10.1101/2020.03.25.20043950 ◽

2020 ◽

Author(s):

Zhixiang Mou ◽

Xu Zhang

Keyword(s):

Acute Kidney Injury ◽

Extracorporeal Membrane Oxygenation ◽

Web Of Science ◽

Meta Analysis ◽

Kidney Injury ◽

Adult Patients ◽

Membrane Oxygenation ◽

Significant Difference ◽

Different Types ◽

Va Ecmo

AbstractAcute kidney injury (AKI) has been reported as one of the most common complications in patients receiving extracorporeal membrane oxygenation (ECMO), yet the risk of AKI on different types of ECMO remains unclear. This meta-analysis aimed to compare risk of AKI among adult patients requiring different types of ECMO. Two authors independently performed a literature search using PubMed, Web of Science, and Embase, encompassing publications up until Arpril 20, 2020 (inclusive). The number of AKI patients, non-AKI patients, patients required RRT and patients not required RRT receiving different types of ECMO were derived and analyzed by STATA. The results indicated there was no significant difference in risk of AKI (OR, 1.54; 95% CI: 0.75-3.16; P= 0.235) and severe AKI required RRT (OR, 1.0; 95% CI: 0.66-1.5, P= 0.994) in patients receiving different types of ECMO. In Conclusion, no difference in risk of AKI and severe AKI required RRT between patients receiving VA ECMO and VV ECMO. More studies are required to support the findings.

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Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis

BMC Geriatrics ◽

10.1186/s12877-021-02512-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tichawona Chinzowu ◽

Sandipan Roy ◽

Prasad S. Nishtala

Keyword(s):

Systematic Review ◽

Older Adults ◽

Acute Kidney Injury ◽

Web Of Science ◽

Meta Analysis ◽

Adult Population ◽

Kidney Injury ◽

Organ Injury ◽

Funnel Plot ◽

General Adult Population

Abstract Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for organ injury risk among older adults following antimicrobial exposure. This systematic review and meta-analysis examined the relationship between antimicrobial exposure and organ injury in older adults. Methodology We searched for original research articles in PubMed, Embase.com, Web of Science core collection, Web of Science BIOSIS citation index, Scopus, Cochrane Central Register of Controlled Trials, ProQuest, and PsycINFO databases, using key words in titles and abstracts, and using MeSH terms. We searched for all available articles up to 31 May 2021. After removing duplicates, articles were screened for inclusion into or exclusion from the study by two reviewers. The Newcastle-Ottawa scale was used to assess the risk of bias for cohort and case-control studies. We explored the heterogeneity of the included studies using the Q test and I2 test and the publication bias using the funnel plot and Egger’s test. The meta-analyses were performed using the OpenMetaAnalyst software. Results The overall absolute risks of acute kidney injury among older adults prescribed aminoglycosides, glycopeptides, and macrolides were 15.1% (95% CI: 12.8–17.3), 19.1% (95% CI: 15.4–22.7), and 0.3% (95% CI: 0.3–0.3), respectively. Only 3 studies reported antimicrobial associated drug-induced liver injury. Studies reporting on the association of organ injury and antimicrobial exposure by age or duration of treatment were too few to meta-analyse. The funnel plot and Egger’s tests did not indicate evidence of publication bias. Conclusion Older adults have a significantly higher risk of sustaining acute kidney injury when compared to the general adult population. Older adults prescribed aminoglycosides have a similar risk of acute kidney injury to the general adult population.

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High burden of acute kidney injury in COVID-19 pandemic: systematic review and meta-analysis

Journal of Clinical Pathology ◽

10.1136/jclinpath-2020-207023 ◽

2020 ◽

pp. jclinpath-2020-207023

Author(s):

Camila Barbosa Oliveira ◽

Camilla Albertina Dantas Lima ◽

Gisele Vajgel ◽

Antonio Victor Campos Coelho ◽

Paula Sandrin-Garcia

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Critically Ill ◽

Random Effects ◽

Meta Analysis ◽

Kidney Injury ◽

Random Effects Model ◽

Risk Of Death ◽

Meta Analyses ◽

The Impact

AimsHospitalised 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.MethodsWe 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.ResultsFrom 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%).ConclusionThe 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.

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Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis

Nutrients ◽

10.3390/nu12092809 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2809

Author(s):

Ban-Hock Khor ◽

Hui-Ci Tiong ◽

Shing Cheng Tan ◽

Raha Abdul Rahman ◽

Abdul Halim Abdul Gafor

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Clinical Outcomes ◽

Nutritional Assessment ◽

Meta Analysis ◽

Kidney Injury ◽

Cochrane Library ◽

Protein Energy Wasting ◽

Nutritional Parameters ◽

Protein Energy

Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36–2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.

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Prevalence of acute kidney injury after cardiac surgery:A systematic review and meta-analysis on risk factors and different diagnostic criterias(AKIN,RIFLE,KDIGO)

10.21203/rs.2.17474/v1 ◽

2019 ◽

Author(s):

Alii Alidadii ◽

Morteza Salarzaei ◽

Fatem Parooe

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

Meta Analysis ◽

Kidney Injury ◽

World Health ◽

Cochrane Library ◽

Common Symptom ◽

Total Prevalence

Abstract Objective: This systematic review and meta-analysis aimed to determine the incidence and some of risk factors of AKI after cardiac surgery using all three diagnostic criteria (AKIN,RIFLE, and KIDGO).Method: We searched for published literature in the English language in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID) , KoreaMed and LILACS, and we searched OpenGrey (www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (who.int/ictrp) for unpublished literature and ongoing studies.To ensure the literature saturation, the list of the included research references or the relevant reviews found by searching was studied(MS). The keywords used in the search strategy were Acute kidney injury,acute renal failure, creatinine,cardiac surgery,heart surgury, Coronary artery bypass grafting(CABG),valve replacement,RIFLE (risk, injury, failure, loss, end-stage renal disease) ,Acute Kidney Injury Network (AKIN),KDIGO (Kidney Disease: Improving Global Outcomes) , which were combined using the AND, OR, and NOT operators.Results: A total of 33298 patients who had undergone the cardiac surgery were studied. Based on the random effect model the total prevalence of AKI in 33298 patients undergone the heart surgery was 26.3% (95% confidence interval[CI]:26.1%,26.6%, I2=99.5%). the total prevalence of AKI in patients undergone cardiac surgery based on AKIN criteria was 21.6% (95% CI –21.2%, 22.1%,I2=98.5%) of whom 21.6% (95% CI-21.2%,22.1%,I2=98.5%) were classified as AKIN stage 1, whereas 3% (95% CI-2.7%%,3.4%%,I2=90.6%) were classified as AKIN stage 2, and 3.2% (95% CI-3.0%%,3.4%%,I2=97.2%) were classified as AKIN stage 3. the total prevalence of AKI in patients undergone cardiac surgery based on RIFLE criteria was 26.0%% (95% CI –25.6%, 26.5%,I2=99.4%). total prevalence of AKI in patients undergone cardiac surgery based on KDIGO criteria was 34.7% (95% CI –33.8%, 35.7%,I2=98.4%). the highest prevalence of AKI in patients undergone cardiac surgery was in Brazil 45.7% (95% CI –43.6%, 47.8%) based on 3 articles included followed by USA with a prevalence of 29.6%(95% CI –28.7%, 29.4%) based on 7 articles included, Uruguay with a prevalence of 36.1%(95% CI –35%, 37.2%) based on 1 article, Canada with a prevalence of 16.7%(95% CI –15.7%, 17.6%) based on 4 articles included and Italy with a prevalence of 10.6%(95% CI –9.8%, 11.3%) based on 3 articles included.Conclusion: AKI after cardiac surgery is a common symptom, although most often more severe in elderly patients. The prevalence of AKI after cardiac surgery based on KDIGO criteria was found to be higher than RIFLE and AKIN. The prevalence of AKI regardless of the definition used showed a decreasing trend from 2009 to 2019. Our findings pointed to the superiority of the KDIGO criterion over RIFLE and AKIN for diagnosing and evaluating AKI after cardiac surgery. However, the widespread acceptance of consensus definitions ( RIFLE and AKIN criteria) for AKI is still reflected in the studies. In order to progress further, establishment of a uniform definition for AKI seems necessary.

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Combined Effects of tDCS and Language/Cognitive Intervention on the Naming of Dementia Patients: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v49i5.3199 ◽

2020 ◽

Author(s):

Haewon BYEON

Keyword(s):

Cognitive Training ◽

Literature Search ◽

Web Of Science ◽

Meta Analysis ◽

Cognitive Intervention ◽

Scientific Basis ◽

The Other ◽

Cochrane Library ◽

Combined Effects ◽

Dementia Patients

Background: The evidence of transcranial direct current stimulation (tDCS) treatment effects on dementia is still insufficient. This study aimed to prove the scientific basis of tDCS by conducting a meta-analysis of previous studies that examined the effects of tDCS on the naming of patients with dementia. Methods: The literature search was conducted for publications published from Jan 2000 to Jun 2019 using four academic databases (PubMed, Web of Science, MEDLINE, and Cochrane Library). This study found 129 publications by searching academic databases according to the PRISMA protocol. Among them, irrelevant studies were excluded, and finally, 4 studies were meta-analyzed. Results: The score of the quality assessment on five studies ranged from 21 to 26 points, rated good or better. Meta-analysis results, tDCS had no significant effect on the improvement of naming ability of dementia. On the other hand, the effect size of the tDCS intervention + language/cognitive training was significant ‘large effect (SMD=0.72, 95% CI: 0.05, 1.39)’. Conclusion: This combination of tDCS and language/cognitive training significantly improved the naming ability of dementia patients.

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The Predictive Value of Urinary Kidney Injury Molecular 1 for the Diagnosis of Contrast-Induced Acute Kidney Injury after Cardiac Catheterization: A Meta-Analysis

Journal of Interventional Cardiology ◽

10.1155/2020/4982987 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Qing Li ◽

Yimin Huang ◽

Weifeng Shang ◽

Ying Zhang ◽

Yanyan Liu ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Catheterization ◽

Predictive Value ◽

Meta Analysis ◽

Characteristic Curve ◽

Kidney Injury ◽

Population Characteristics ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Summary Receiver Operating Characteristic

Background. Urinary kidney injury molecule 1 (uKIM-1) is a proximal tubular injury biomarker for predicting acute kidney injury (AKI); its prognostic value varies depending on the clinical and population characteristics. However, the predictive value of uKIM-1 for diagnosis of contrast-induced acute kidney injury (CI-AKI) remains unclear. Method. Medline, Embase, ClinicalTrials.gov, Cochrane Library database, and the China National Knowledge Infrastructure (CNKI) were used to identify relevant studies from their inception to November 31, 2019. Studies that met the inclusion criteria were included. Relevant data were extracted to obtain pooled sensitivity (SEN) and specificity (SPE), summary receiver operating characteristic curve (ROC), and area under the ROC (AUC or AUROC). A bivariate mixed-effects regression model was used for data analysis. Results. A total of 946 patients from 8 eligible studies were included. Across all the studies, the diagnostic odds ratio (DOR) for uKIM-1 level to predict CI-AKI was 19 (95% CI 10–39), with SEN and SPE of 0.84 and 0.78, respectively. The AUROC for uKIM-1 in predicting CI-AKI was 0.88 (95% CI 0.85–0.90). There was a substantial heterogeneity across the studies (I2 was 37.73% for the summary sensitivity and 69.31% for the summary specificity). Conclusion. Urinary KIM-1 has a high predictive value for diagnosis of CI-AKI in patients who have undergone cardiac catheterization.

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Levosimendan Reduces Mortality and Low Cardiac Output Syndrome in Cardiac Surgery

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-3400496 ◽

2019 ◽

Vol 68 (05) ◽

pp. 401-409

Author(s):

Antje Christin Deppe ◽

Thorsten C. W. Wahlers ◽

Carolyn Weber ◽

Matthias Esser ◽

Kaveh Eghbalzadeh ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Output ◽

Cardiac Surgery ◽

Literature Search ◽

Meta Analysis ◽

Kidney Injury ◽

Controlled Trials ◽

Low Cardiac Output Syndrome ◽

Low Cardiac Output ◽

Randomized Controlled

Abstract Background There has been conflicting evidence concerning the effect of levosimendan on clinical outcomes in patients undergoing cardiac surgery. Therefore, we performed a systematic review and conducted this meta-analysis to provide evidence for/against the administration of levosimendan in cardiac surgery patients. Methods We performed a meta-analysis from literature search in PubMed, EMBASE, and Cochrane Library. Only randomized controlled trials comparing the administration of levosimendan in cardiac surgery patients with a control group (other inotrope, standard therapy/placebo, or an intra-aortic balloon pump) were included. In addition, at least one clinical outcome had to be mentioned: mortality, myocardial infarction, low cardiac output syndrome (LCOS), acute kidney injury, renal replacement therapy, atrial fibrillation, prolonged inotropic support, length of intensive care unit, and hospital stay. The pooled treatment effects (odds ratio [OR], 95% confidence intervals [CI]) were assessed using a fixed or random effects model. Results The literature search retrieved 27 randomized, controlled trials involving a total of 3,198 patients. Levosimendan led to a significant reduction in mortality (OR: 0.67; 95% CI: 0.49–0.91; p = 0.0087). Furthermore, the incidence of LCOS (OR: 0.56, 95% CI: 0.42–0.75; p < 0.0001), acute kidney injury (OR: 0.63; 95% CI: 0.46–0.86; p = 0.0039), and renal replacement therapy (OR: 0.70; 95% CI: 0.50–0.98; p = 0.0332) was significantly decreased in the levosimendan group. Conclusion Our meta-analysis suggests beneficial effects for the prophylactic use of levosimendan in patients with severely impaired left ventricular function undergoing cardiac surgery. The administration of levosimendan was associated with a reduced mortality, less LCOS, and restored adequate organ perfusion reflected in less acute kidney injury.

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