The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis

Pranata, Raymond; Supriyadi, Rudi; Huang, Ian; Permana, Hikmat; Lim, Michael Anthonius; Yonas, Emir; Soetedjo, Nanny Natalia M; Lukito, Antonia Anna

OBJECTIVE: The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients. METHODOLOGY: A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator. RESULTS: Nineteen studies with a total of 7216 patients were included. CKD was associated with increased composite poor outcome (RR 2.63 [1.33, 5.17], P = .03; I(2) = 51%, P = .01) and its subgroup, consisting of mortality (RR 3.47 [1.36, 8.86], P = .009; I(2) = 14%, P = .32) and severe COVID-19 (RR 2.89 [0.98, 8.46], P = .05; I(2) = 57%, P = .04). RRT was associated with increased composite poor outcome (RR 18.04 [4.44, 73.25], P < .001; I(2) = 87%, P < .001), including mortality (RR 26.02 [5.01, 135.13], P < .001; I(2) = 60%, P = .06), severe COVID-19 (RR 12.95 [1.93, 86.82], P = .008; I(2) = 81%, P < .001), intensive care (IC) (RR 14.22 [1.76, 114.62], P < .01; I(2) = 0%, P < .98), and use of mechanical ventilator (RR 34.39 [4.63, 255.51], P < .0005). CONCLUSION: CKD and new-onset RRT were associated with poor outcome in patients with COVID-19.