The COVID-19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta-analysis

Abstract

Aim: This systematic review aims to evaluate the effect of the COVID-19 pandemic on access to health care for patients with CKD. Methods: MEDLINE and EMBASE databases were searched up to July 2021 (PROSPERO CRD42021230831). Data relevant to access to health care before and during the COVID-19 pandemic were extracted, including outcomes related to access to general nephrology consultations, telehealth, dialysis services and kidney transplantations. Relative and absolute effects were pooled using a random effects model to account for between-study heterogeneity. Risk of bias was assessed using a modified Quality in Prognostic Studies tool. The certainty of the evidence was rated using the GRADE approach. Results: Twenty-three studies across five WHO regions were identified. Reductions in transplantation surgeries were observed during the COVID-19 pandemic compared with the pre-COVID-19 era (risk ratio = 2.15, 95%CI = 1.51–3.06, I2 = 90%, p