Renal complications in COVID-19: A systematic review and meta-analysis

Setor K Kunutsor*, Jari A Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

116 Citations (Scopus)
39 Downloads (Pure)


Purpose: Emerging data suggests coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluate renal complications of COVID-19 and their incidence using a systematic meta-analysis.

Design: Observational studies reporting renal complications in COVID-19 patients were sought from MEDLINE, Embase and the Cochrane Library from 2019 to June 2020. The nine-star Newcastle-Ottawa Scale was used to evaluate methodological quality. Incidence with 95% confidence intervals (CIs) were pooled using random-effects models.

Results: We included 22 observational cohort studies comprising of 17,391 COVID-19 patients. Quality scores of studies ranged from 4-6. The pooled prevalence of pre-existing chronic kidney disease (CKD) and end-stage kidney disease was 5.2% (2.8-8.1) and 2.3% (1.8-2.8) respectively. The pooled incidence over follow-up of 2-28 days was 12.5% (10.1-15.0) for electrolyte disturbance (eg, hyperkalaemia), 11.0% (7.4-15.1) for acute kidney injury (AKI) and 6.8% (1.0-17.0) for renal replacement therapy (RRT). In subgroup analyses, there was a higher incidence of AKI in US populations and groups with higher prevalence of pre-existing CKD.

Conclusions: Frequent renal complications reported among hospitalised COVID-19 patients are electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes.
Original languageEnglish
Number of pages10
JournalAnnals of Medicine
Issue number7
Publication statusPublished - 10 Jul 2020

Structured keywords

  • Covid19


  • COVID-19
  • Renal complications
  • acute kidney injury
  • meta-analysis


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