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Introduction Acute kidney injury (AKI) is a common complication of COVID-19 in hospitalised patients, particularly during the early phases of the pandemic. Initial studies documented high AKI prevalence, while subsequent waves suggested a decline. Understanding these temporal patterns is essential to inform clinical management and healthcare planning. This study aims to assess trends in COVID-19-associated AKI prevalence over time through a systematic review and meta-analysis.Theory This study is grounded in epidemiological and clinical frameworks that examine disease progression and complications overtime. AKI was consistently defined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Meta-analysis was done for pooled AKI prevalence for each calendar year to evaluate changes in prevalence across different pandemic phases.Method A systematic search of PubMed, Embase, Scopus, Web of Science and Cochrane Library identified English-language studies published from January 2020 to November 2023. Eligible designs included observational, retrospective, prospective and longitudinal cohort studies reporting COVID-associated AKI.Results Twelve studies comprising 31,441 hospitalised COVID-19 patients were included, six of which involved ICU-only cohorts. A general decline in AKI prevalence and mortality was observed over time. Ten studies reported lower AKI prevalences in later waves compared to earlier ones; however, these trends did not reach statistical significance in meta-analyses.Discussion Our study showed a temporal trend where COVID-19 AKI prevalence was higher during the early stages of the COVID-19 pandemic compared to later waves. Further research is required to explore the underlying mechanisms driving this decline in COVID-associated AKI prevalence and to continue improving kidney health in future pandemic scenarios.
Dai et al. (Mon,) studied this question.