Prevalence of chronic kidney diseases among people living with HIV in Ethiopia: a systematic review and meta-analysis

Abstract

Background

Chronic kidney disease (CKD) is a common condition among people living with HIV worldwide, but it is more common in patients from Africa. Both opportunistic infections and chronic illnesses are responsible for a large proportion of people living with HIV in low-resource settings like Ethiopia, which are linked to higher rates of morbidity and mortality. Further, as CKD is acknowledged as a major global public health issue affecting productivity, health, and healthcare costs, the goal of this systematic review and meta-analysis was to ascertain the pooled prevalence of CKD among people living with HIV in Ethiopia.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria were followed by us when we carried out a systematic review and meta-analysis. Electronic databases like PubMed, Google Scholar, African Journal Online, Science Direct, Embase, Research Gate, Scopus, and Web of Sciences were searched in order to find pertinent articles. Domain-based assessment was used to evaluate the listed studies' quality. Stata version 14.0 software was used to conduct the statistical analysis. We used the Cochran's Q test and I² statistics to assess heterogeneity. Using Egger's test and a funnel plot analysis, publication bias was evaluated. Using a random effect model, the pooled prevalence was calculated. Sub-group and sensitivity studies were also carried out.

Results

This systematic review and meta-analysis included 12 articles from Ethiopia, and 3364 People living with HIV were included. The overall pooled prevalence of chronic kidney disease (CKD) among People living with HIV in Ethiopia was 18.10% (95% CI: 14.17–22.03). According to the CKD calculation, the pooled prevalence of CKD was 18.06 (95% CI: 10.62–25.49) by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and 18.38 (95% CI: 15.75–21.02) by using the Modification of Diet in Renal Diseases (MDRD) formula. Using random-effect model, the I² test result showed high heterogeneity I² = 89.7% and P < 0.001. Additionally, Egger’s test of publication bias P-value was 0.017.

Conclusion

People living with HIV had a high prevalence of CKD, according to this systematic review and meta-analysis. Consequently, frequent CKD diagnosis at baseline, antiretroviral therapy follow-up and screening improves the quality of life for People living with HIV. Systematic review registration: PROSPERO (2023: CRD42023431245).