新型冠状病毒肺炎患者急性肾损伤的发病率、危险因素及转归：系统评价的系统综述

Incidence, risk factors and outcomes of acute kidney injury among COVID-19 patients: A systematic review of systematic reviews.

作者信息

Mallhi Tauqeer Hussain, Khan Yusra Habib, Alzarea Abdulaziz Ibrahim, Khan Faiz Ullah, Alotaibi Nasser Hadal, Alanazi Abdullah Salah, Butt Muhammad Hammad, Alatawi Ahmed D, Salman Muhammad, Alzarea Sami I, Almalki Ziyad Saeed, Alghazi Mansoor A, Algarni Majed Ahmed

机构信息

Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia.

Health Sciences Research Unit, Jouf University, Sakaka, Saudi Arabia.

出版信息

Front Med (Lausanne). 2022 Nov 4;9:973030. doi: 10.3389/fmed.2022.973030. eCollection 2022.

DOI:10.3389/fmed.2022.973030

PMID:36405588

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9672072/

Abstract

UNLABELLED

The COVID-19 associated acute kidney injury (CAKI) has emerged as a potential intricacy during the management of patients. Navigating the rapidly growing body of scientific literature on CAKI is challenging, and ongoing critical appraisal of this complication is essential. This study aimed to summarize and critically appraise the systematic reviews (SRs) on CAKI to inform the healthcare providers about its prevalence, risk factors and outcomes. All the SRs were searched in major databases (PubMed, EMBASE, Web of Science) from inception date to December 2021. This study followed SR of SRs methodology, all the records were screened, extracted and subjected to quality assessment by assessing the methodological quality of systematic reviews (AMSTAR-2). The extracted data were qualitatively synthesized and tabulated. This review protocol was registered in PROSPERO (CRD42022299444). Of 3,833 records identified; 42 SRs were included in this overview. The quality appraisal of the studies showed that 17 SRs were of low quality, while 8 moderate and 17 were of high-quality SRs. The incidence of CAKI ranged from 4.3% to 36.4% in overall COVID-19 patients, 36%-50% in kidney transplant recipients (KTRs), and up to 53% in severe or critical illness. Old age, male gender, cardiovascular disease, chronic kidney disease, diabetes mellitus and hypertension were frequently reported risk factors of CAKI. The need of renal replacement therapy (RRT) was up to 26.4% in overall COVID-19 patients, and 39% among those having CAKI. The occurrence of acute kidney injury (AKI) was found independent predictor of death, where mortality rate among CAKI patients ranged from 50% to 93%. This overview of SRs underscores that CAKI occurs frequently among COVID-19 patients and associated with high mortality, need of RRT and adverse outcomes. However, the confidence of these results is moderate to low which warrants the need of more SRs having established methodological standards.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299444], identifier [CRD42022299444].

摘要

未标注

新型冠状病毒肺炎相关急性肾损伤（CAKI）已成为患者管理过程中的一个潜在复杂问题。梳理关于CAKI迅速增长的科学文献具有挑战性，对这一并发症进行持续的批判性评估至关重要。本研究旨在总结并批判性评估关于CAKI的系统评价（SRs），以便为医疗保健提供者提供有关其患病率、危险因素和结局的信息。从起始日期到2021年12月，在主要数据库（PubMed、EMBASE、Web of Science）中检索了所有的SRs。本研究遵循系统评价的系统评价方法，对所有记录进行筛选、提取，并通过评估系统评价的方法学质量（AMSTAR-2）进行质量评估。对提取的数据进行定性综合并制成表格。本综述方案已在PROSPERO（CRD42022299444）中注册。在识别出的3833条记录中，本综述纳入了42篇SRs。研究的质量评估表明，17篇SRs质量较低，8篇中等质量，17篇高质量。在总体新型冠状病毒肺炎患者中，CAKI的发生率为4.3%至36.4%，在肾移植受者（KTRs）中为36%至50%，在重症或危重症患者中高达53%。年龄较大、男性、心血管疾病、慢性肾脏病、糖尿病和高血压是CAKI常见的危险因素。在总体新型冠状病毒肺炎患者中，需要肾脏替代治疗（RRT）的比例高达26.4%；在发生CAKI的患者中，这一比例为39%。急性肾损伤（AKI）的发生是死亡的独立预测因素，CAKI患者的死亡率在50%至93%之间。本SRs综述强调，CAKI在新型冠状病毒肺炎患者中频繁发生，并与高死亡率、需要RRT及不良结局相关。然而，这些结果的可信度为中等至低，这表明需要更多具有既定方法学标准的SRs。