Abere Woretaw Azagew, Hailemichael Kindie, Chilot Kassa, Yohannes Mulu
Background: Acute kidney injury (AKI) is a rapid loss of the kidney’s excretory function, resulting in an accumulation of end products of nitrogen metabolism. The prevalence and predictors of AKI among HIV-positive patients were inconsistent among studies reported in Africa. Therefore, this study aimed to generate robust and up-to-date evidence on the prevalence and identify predictors of AKI among HIV-positive patients in Africa.
Methods: We searched on PubMed, Embas, Ebsco, OVID, Cochrane Library, and other supplementary search engines (Google and Google Scholar). The quality of the study was assessed using the Newcastle-Ottawa Scale. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata version 14 for analysis. A random effect meta-analysis model was used to estimate the pooled prevalence of AKI. Heterogeneity was evaluated using Cochrane Q statistics and I squared (I2). Furthermore, the graphic asymmetric test of the funnel plot and/or Egger’s tests were computed to detect publication bias. To treat the publication bias, a trim and fill analysis was carried out. PROSPERO reference number: CRD42023446078.
Results: In total, twenty-four original articles comprising 7913 HIV-positive patients were included in the study. The pooled prevalence of AKI was found to be 23.35% (95% CI: 18.14-28.56%, I2 = 97.7%, p-value <0.001). Low hemoglobin (Hgb <8 mg/dl) was found to be the determinant factor for AKI (AOR = 2.4; 95% CI: 1.69-3.4, I2 = 0.0%, p-value = 0.40).
Conclusions: The pooled prevalence of AKI among HIV-positive patients was high. HIV-positive patients with low hemoglobin levels are at risk of developing AKI
