Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis

•Acute kidney injury (AKI) in COVID-19 patients remains a noteworthy problem.•AKI frequently occurs among ICU patients and kidney transplant recipients.•Early intervention should be called upon for AKI patients. Reported rates of acute kidney injury (AKI) have varied significantly among studies of coronavirus disease 2019 (COVID-19) published to date. The present meta-analysis was conducted to gain clarity regarding AKI incidence and renal replacement therapy (RRT) use in COVID-19 patients. The PubMed, Embase, Web of Science, medRxiv, and bioRxiv databases were systematically searched for COVID-19-related case reports published through 25 July 2020. Pooled analyses were conducted using R. The pooled incidence of AKI in 51 studies including 21,531 patients was 12.3% (95% CI 9.5–15.6%), with higher rates of 38.9% in 290 transplant patients (95% CI 27.3–51.9%), 39.0% in 565 ICU patients (95% CI 23.2–57.6%) and 42.0% among 1745 deceased patients (95% CI 30.3–54.7%). RRT usage was reported in 39 studies of 17,664 patients, with an overall pooled use of 5.4% (95% CI 4.0–7.1%), with higher rates of 15.6% in 117 transplant patients (95%CI 9.9–23.8%) and 16.3% in 776 ICU patients (95% CI 11.1–23.3%). AKI and RRT use among COVID-19 patients represent a major public health concern, and early and appropriate intervention should be called upon to improve the prognosis of patients suffering from AKI.