Global geographic and socioeconomic disparities in COVID-associated acute kidney injury: a systematic review and meta-analysis
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of COVID-19, which significantly increases the risk of mortality. There has been a wide range of AKI prevalence reported throughout the pandemic, reflecting differences in geographic location, patient characteristics, and health care resources. We aimed to provide a global overview of the COVID-19 AKI prevalence reported in published studies to uncover geographic and socioeconomic disparities.
METHODS: We undertook a systematic review and meta-analysis, searching PubMed, Embase, Scopus, Web of Science, and Cochrane Library for full-text articles published in English reporting the prevalence of AKI from January 2020 to November 2023. All studies defined AKI according to the Kidney Disease Improving Global Outcomes criteria. Clinical characteristics were extracted and examined from 334 studies that met the inclusion criteria. With significant study heterogeneity, random-effect models were estimated. We reported pooled AKI prevalence by country, region, and income level. Meta-regression further examined the relationship between COVID-associated AKI and geographic location.
RESULTS: After removing studies that utilised the same data, 345 796 patients from 246 studies were included, covering 49 countries. Of 246 studies, 137 came from high-income countries, whereas only three were conducted in low-income countries. Among non-intensive care unit (ICU) patients, low-income countries had the lowest COVID-19…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 345 participants or records.
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