Incidence and risk predictors of acute kidney injury among HIV-positive patients presenting with sepsis in a low resource setting

Kimweri, Davis; Ategeka, Julian; Ceasor, Faustine; Muyindike, Winnie; Nuwagira, Edwin; Muhindo, Rose

doi:10.1186/s12882-021-02451-6

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…It has been reported that approximately 6.0–48.5% of HIV-infected patients had a renal disease in Africa and 6.24–83% of these cases were HIVAN [ 2 ]. AKI secondary to sepsis was another major complication in sick HIV-infected patients with acquired immunodeficiency syndrome (AIDS) [ 13 ]. Numerous forms of the IC-mediated glomerular disease have been reported in HIV-positive individuals [ 14 ], referred to as HIV-associated IC kidney disease (HIVICK) with a specific description of the pattern of IC disease in the setting of HIV.…”

Section: Epidemiology and Clinical Presentationsmentioning

confidence: 99%

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

et al. 2021

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Kidney disease is a major complication of viral infection, which can cause both acute and chronic kidney diseases via different mechanisms such as immune-mediated injury, kidney cell injury from a direct viral infection, systemic effects, and antiviral drug-induced nephrotoxicity. HIV-associated nephropathy (HIVAN), characterized by collapsing focal segmental glomerulosclerosis (cFSGS), has been described 2 decades ago as a major complication of acquired-immunodeficiency syndrome. The pathogenesis of HIVAN has been well studied, including viral entry, host response, and genetic factors. The incidence of this disease has been dramatically dropped with current antiretroviral therapy. In the recent severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic, acute kidney injury was also found to be a major complication in patients with (coronavirus disease) COVID-19. These patients also developed glomerular disease such as cFSGS in African Americans with apolipoprotein L1 risk alleles, similar to HIVAN. Whether SARS-CoV-2 can infect kidney cells locally remains controversial, but both local infection and systemic effects are likely involved in the pathogenesis of this disease. In this review, we present a comparison of the clinical presentations, pathological findings, disease mechanisms, and potential treatments between HIVAN and COVID-19. Leveraging the knowledge in HIVAN and experimental approaches used to study HIVAN will facilitate the exploration in the pathogenesis of COVID-19-associated kidney disease and improve our management of COVID-19 patients.

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Section: Epidemiology and Clinical Presentationsmentioning

confidence: 99%

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

et al. 2021

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“…At this time, renal function may have been seriously damaged. There is a lag in the diagnosis of AKI by Scr [17,18]. It is urgent to screen sensitive and reliable biomarkers for early diagnosis of AKI and its early treatment, so as to improve the prognosis and survival rate of patients with sepsis [19].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of urinary neutrophil gelatinase associated lipocalin in the early diagnosis of acute kidney injury with sepsis

2024

Am J Transl Res

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Background: To assess the utility of urinary neutrophil gelatinase associated lipocalin (uNGAL) in the diagnosis of acute kidney injury (AKI) in the context of sepsis. Methods: In this retrospective study, a total of 142 patients with sepsis treated in the Third Hospital of Shanxi Medical University from January 2019 to January 2021 were included. Patients diagnosed with AKI complicated with sepsis were categorized into the AKI group (n=70 cases), and patients diagnosed with sepsis were classified into the non-AKI group (n=72 cases). We collected and analyzed data on serum creatinine (Scr) and uNGAL levels. The ROC (receivers operating characteristics) curve was used to evaluate the sensitivity and specificity of uNGAL in the diagnosis of AKI with sepsis. Results: The level of uNGAL in the AKI group increased over time following admission, which was not observed in the non-AKI group. Twenty-four hours after admission, the level of uNGAL in the AKI group was significantly higher than that in the non-AKI group (P < 0.05), but there was no significant difference in Scr level between the two groups (P > 0.05). At 72 hours after admission, the AUC of uNGAL in predicting AKI was 0.989 (95% CI: 1.018-1.085), and its intercept value was 961.3 ng/ml. At the same time, the correlation analysis showed that the level of uNGAL was positively correlated with the occurrence of AKI. Conclusion: uNGAL is superior to Scr for early diagnosis of AKI patients with sepsis.

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“…Finally, twenty-four articles were retrieved and included in the review, with a total of 9713 populations. Of the twenty-four studies, five were from Ethiopia [19][20][21][22][23], four from Tanzania [24][25][26][27], four from Nigeria [28][29][30][31], two from Uganda [32,33], one from Kenya [34], one from Cameroon [35], one from South Africa [36], one from Malawi [37], one from Senegal [38], one from Zambia [39], one from Rwanda [40], one from Burkina Faso [41], and one from DR Congo [42]. The pooled prevalence was calculated from the aforementioned studies, whereas for predictors of AKI, three studies for hemoglobin level [19,35,41], six studies for CD4 count [19,20,[24][25][26]31], and three studies for WHO clinical HIV staging [20,26,35] were used.…”

Section: Study Selection and Characteristics Of Included Studiesmentioning

confidence: 99%

Acute kidney injury and its predictors among HIV-positive patients in Africa: Systematic review and meta-analysis

Azagew,

Abate,

Ferede

et al. 2024

PLoS ONE

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Background cute kidney injury(AKI) is a rapid loss of the kidney’s excretory function, resulting in an accumulation of end products of nitrogen metabolism. The causes of AKI in HIV-positive patients are not well investigated, but it may be associated with antiretroviral drug side effects and HIV itself. Even though there were studies that reported the prevalence of AKI among HIV-positive patients in Africa, their findings were inconsistent across the studies. Methods We searched on PubMed, Embas, Ebsco, OVID, Cochrane Library, and other supplementary search engines, including Google and Google Scholar. Articles published upto July 2023 were included in this review study. The quality of the study was assessed using the Newcastle-Ottawa Scale for cross-sectional, case-control, and cohort studies. 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 among HIV-positive patients. 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. Sensitivity analysis was computed to see the effect of a single study on the summary effects. To treat the publication bias, a trim and fill analysis was carried out. The protocol of this review has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO),with reference number CRD42023446078. Results A total of twenty-four original articles comprising 7913HIV-positive patients were included in the study. The pooled prevalence of AKI among HI-positive patients was found to be 23.35% (95% CI: 18.14–28.56%, I2 = 97.7%, p-value <0.001). Low hemoglobin (Hgb <8mg/dl) was found to be the determinant factor for AKI among HIV-positive patients (AOR = 2.4; 95% CI:1.69–3.4, I2 = 0.0%, p-value = 0.40). In meta-regression analysis, sample size was the possible source of variation among the included studies (AOR = 3.11, 95%CI: 2.399–3.83). 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. Hence, regular monitoring of kidney function tests is needed to prevent or delay the risk of AKI among HIV-positive patients. Healthcare workers should provide an integrated healthcare service to HIV-positive patients on the prevention, treatment, and reduction of the progression of AKI to advanced stages and complications.

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Incidence and risk predictors of acute kidney injury among HIV-positive patients presenting with sepsis in a low resource setting

Cited by 4 publications

References 16 publications

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

Evaluation of urinary neutrophil gelatinase associated lipocalin in the early diagnosis of acute kidney injury with sepsis

Acute kidney injury and its predictors among HIV-positive patients in Africa: Systematic review and meta-analysis

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