Kidney Dysfunction and Associated Factors Among Adults Living with Human Immuno-deficiency Virus in Africa: a Systematic Review and Meta-analysis

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2025 Feb 11

PMID 39934651

Authors

Worku Chekol Tassew

Agerie Mengistie Zeleke

Yeshiwas Ayale Ferede

Girum Meseret Ayenew

Affiliations

Soon will be listed here.

Abstract

Background: Kidney dysfunction among adults living with Human Immuno-Deficiency Virus (HIV) increases the risk of drug-related side effects, acute kidney injury, hospitalization, and progression to end-stage kidney disease. In developing regions like Africa, where access to kidney transplants and dialysis is limited, early detection of kidney disease among adults living with HIV has significant clinical and financial implications. Therefore, the objective of this review was to determine the pooled prevalence and identify associated factors of kidney dysfunction among adults living with HIV in Africa.

Methods: The report was presented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses checklists. The articles were searched using PubMed/MEDLINE, EMBASE, Scopus, Wiley Online Library, CINAHL/EBSCO, OVID/Wolters Kluwer, Cochrane Library, Google Scholar, Science Direct, and African Journal Online. Data were extracted using Microsoft Excel and exported to STATA MP Version 11 Software for analysis. Heterogeneity of studies was assessed by Cochran's Q test and I statistics. Publication bias was detected by the visual inspection of the funnel plot and statistical Egger's test.

Results: In this study, the pooled prevalence of kidney dysfunction among adults living with HIV in Africa is estimated to be 16.85% (95% CI: 13.08 - 20.62, I²=96.2%, p-value = 0.000). Female sex (POR = 1.82; 95% CI; 1.31, 2.53), age ≥ 50 years (POR = 8.94; 95% CI: 1.82, 43.93), body mass index ≥ 30 kg/m² (POR = 4.70; 95% CI: 3.07, 7.22), diabetes mellitus (POR = 2.84; 95% CI: 1.59, 5.07), CD4 count < 200 cells/mm³ (POR = 3.64; 95% CI: 1.63, 8.13) and anemia (POR = 3.73, 95% CI = 2.00-6.94) were factors associated with kidney dysfunction among adults living with HIV.

Conclusions: This study revealed that the pooled prevalence of kidney dysfunction among adults living with HIV in Africa remains significant. Female sex, age ≥ 50 years, body mass index ≥ 30 kg/m², diabetes mellitus, CD4 count < 200 cells/mm³ and anemia were factors associated with kidney dysfunction. To reduce the morbidity and mortality associated with kidney dysfunction, it is advisable to create awareness and initiating early interventions through health education during their follow-up time, and initiating suitable medication at an early stage.

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