Jalo Rabiu Ibrahim, Tsiga-Ahmed Fatimah Ismail, Kwaku Aminatu Ayaba, Adamu Aishatu Lawal, Amole Taiwo Gboluwaga, Garzali Ibrahim Umar, Umar Zainab Abdulazeez, Muhammad Ibrahim Danladi, Adamu Halima, Kyari Fatime Othman, Jibril Yasir Nuhu, Yusuf Mustapha Ahmed, Babatunde Ademola Lawrence, Ismail Hasiya Tijjani, Nalado Aisha Muhammad, Sani Mahmoud Umar, Wester William, Aliyu Muktar Hassan
Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.
Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria.
J Nephrol. 2024 Dec 26. doi: 10.1007/s40620-024-02172-7.
Pregnancy-Related Acute Kidney Injury (PRAKI) is an important contributor to maternal-fetal morbidity and mortality. The burden of PRAKI in sub-Saharan Africa is not well documented. We conducted a systematic literature review and meta-analysis to estimate the prevalence of PRAKI in sub-Saharan Africa.
We systematically searched the literature published between January 2000 and May 2024 on PubMed, Embase, Scopus, and African Journals Online. We used a random-effects model to derive the pooled prevalence estimates and analysed trends in prevalence using weighted meta-regression. We assessed the quality of the included studies using the Joanna Briggs Institute critical appraisal tool and evaluated the presence of publication bias using Begg's rank correlation and Egger's test.
Thirteen studies satisfied the inclusion criteria, with a total sample size of 5273 individuals, ranging between 46 and 1547 across the studies. The pooled prevalence of PRAKI was 15.6% (95% CI 11.5-20.1%) with significant heterogeneity in prevalence rates (heterogeneity chi-square: 179.2, p < 0.001, I: 93.4%). We observed an increase in the trend of PRAKI at a rate of 0.8% per year, with insufficient evidence of a difference in prevalence over the years (p = 0.119).
Our findings show a high prevalence of PRAKI and suggest a rising trend in the prevalence of PRAKI within sub-Saharan Africa. Future studies should investigate interventions to improve access to, and the quality of, antenatal care services to reduce maternal-fetal morbidity and mortality.
妊娠相关急性肾损伤（PRAKI）是导致母婴发病和死亡的重要因素。撒哈拉以南非洲地区PRAKI的负担尚无充分记录。我们进行了一项系统的文献综述和荟萃分析，以估计撒哈拉以南非洲地区PRAKI的患病率。
我们系统检索了2000年1月至2024年5月在PubMed、Embase、Scopus和非洲在线期刊上发表的文献。我们使用随机效应模型得出合并患病率估计值，并使用加权元回归分析患病率趋势。我们使用乔安娜·布里格斯研究所的批判性评价工具评估纳入研究的质量，并使用贝格秩相关和埃格检验评估发表偏倚的存在情况。
13项研究符合纳入标准，总样本量为5273人，各研究样本量在46至1547人之间。PRAKI的合并患病率为15.6%（95%CI 11.5-20.1%），患病率存在显著异质性（异质性卡方值：179.2，p<0.001，I：93.4%）。我们观察到PRAKI的患病率以每年0.8%的速度上升，但多年来患病率差异的证据不足（p= 0.119）。
我们的研究结果显示PRAKI的患病率很高，并表明撒哈拉以南非洲地区PRAKI的患病率呈上升趋势。未来的研究应调查改善产前护理服务的可及性和质量的干预措施，以降低母婴发病率和死亡率。
