Effects of COVID-19 Pandemic on Patients with Kidney Disease and Kidney Replacement Therapy: Focus on Black, Asian, and Minority Ethnic Groups: A Systematic Review

Abstract

Background COVID-19 pandemic significantly affected health services globally, resulting in poorer outcomes, especially in patients with chronic long-term illnesses. For patients with chronic kidney disease (CKD), potential effects might include, among others, disruption of dialysis services, reduced kidney transplant rates, and increased incidence of severe COVID-19 infections and death. Such differences may be further exacerbated in patients from Black, Asian, and Minority Ethnic (BAME) populations with CKD. Aim To conduct a systematic review to identify the global impact of COVID-19 on kidney replacement therapy and to determine the extent of any disparities in BAME patients with CKD. Materials and Methods PubMed, Embase (OVID), and CINAHL (EBSCO) databases were searched for relevant studies published between January 1, 2019, and November 24, 2023. Predetermined inclusion/exclusion criteria were utilized to shortlist abstracts. Two reviewers independently appraised articles and systematically extracted data and assessed the quality of studies. Thematic analysis was used for evidence synthesis; no quantitative meta-analysis was conducted. The review was registered with PROSPERO (CRD42020201771). Results Two hundred and eleven abstracts were shortlisted, 52 articles were identified for full-text review, and 20 articles published worldwide were included in the final review. Themes identified included: effects of the COVID-19 pandemic on patients with CKD undergoing dialysis (six studies); impact on kidney transplant recipients and transplant programs (eight studies); and differential impact of COVID-19 on BAME patients in comparison with the general population (six studies). The presence of CKD in patients with COVID-19 was identified as a poor prognostic factor, along with obesity, lower socioeconomic status, and BAME population. Conclusion The findings of this targeted review demonstrate the global impact of COVID-19 on various aspects of kidney replacement therapy and provide evidence of important disparities for BAME patients. In case of any future pandemic, vulnerable groups undergoing hemodialysis and those with kidney allografts will require special attention and care.