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埃塞俄比亚艾滋病毒感染者中慢性肾脏病的患病率:一项系统评价和荟萃分析。

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

作者信息

Eshetu Bruktawit, Gedefie Alemu, Mulatie Zewudu, Alemayehu Ermiyas, Belete Melaku Ashagrie, Tekele Saba Gebremichael, Weldehanna Daniel Gebretsadik, Ebrahim Hussen, Tilahun Mihret, Debash Habtu, Shibabew Agumas, Mohammed Ousman

机构信息

Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, P.o.box:1145, Dessie, Ethiopia.

出版信息

BMC Infect Dis. 2025 Jul 1;25(1):850. doi: 10.1186/s12879-025-11212-x.

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 I 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 I test result showed high heterogeneity I = 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).

摘要

背景

慢性肾脏病(CKD)在全球艾滋病毒感染者中很常见,但在非洲患者中更为常见。在埃塞俄比亚等资源匮乏地区,机会性感染和慢性病是导致很大一部分艾滋病毒感染者患病的原因,这些因素与更高的发病率和死亡率相关。此外,由于慢性肾脏病被公认为是一个影响生产力、健康和医疗成本的重大全球公共卫生问题,本系统评价和荟萃分析的目的是确定埃塞俄比亚艾滋病毒感染者中慢性肾脏病的合并患病率。

方法

我们在进行系统评价和荟萃分析时遵循了系统评价和荟萃分析的首选报告项目标准。搜索了电子数据库,如PubMed、谷歌学术、非洲期刊在线、科学Direct、Embase、研究之门、Scopus和科学网,以查找相关文章。采用基于领域的评估方法来评估所列研究的质量。使用Stata 14.0软件进行统计分析。我们使用 Cochr an Q检验和I统计量来评估异质性。使用Egger检验和漏斗图分析来评估发表偏倚。采用随机效应模型计算合并患病率。还进行了亚组和敏感性研究。

结果

本系统评价和荟萃分析纳入了12篇来自埃塞俄比亚的文章,共纳入3364名艾滋病毒感染者。埃塞俄比亚艾滋病毒感染者中慢性肾脏病的总体合并患病率为18.10%(95%可信区间:14.17 - 22.03)。根据慢性肾脏病的计算方法,使用慢性肾脏病流行病学合作组织(CKD - EPI)公式计算的慢性肾脏病合并患病率为18.06(95%可信区间:10.62 - 25.49),使用肾脏病饮食改良(MDRD)公式计算的患病率为18.38(95%可信区间:15.75 - 21.02)。采用随机效应模型,I检验结果显示异质性较高,I = 89.7%,P < 0.001。此外,Egger发表偏倚检验的P值为0.017。

结论

根据本系统评价和荟萃分析,艾滋病毒感染者中慢性肾脏病的患病率较高。因此,在基线时频繁进行慢性肾脏病诊断、抗逆转录病毒治疗随访和筛查可提高艾滋病毒感染者的生活质量。

系统评价注册

PROSPERO(2023:CRD42023431245)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b4b/12219290/40641ce91d2e/12879_2025_11212_Fig1_HTML.jpg

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