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. 2022 Dec;35(9):2175-2189.
doi: 10.1007/s40620-022-01349-2. Epub 2022 Jun 16.

Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Ahmed Saad Shalaby  1 , Rasha Samir Shemies  2
Affiliations

Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Ahmed Saad Shalaby et al. J Nephrol. 2022 Dec.

Erratum in

Abstract

Background: Pregnancy-Related Acute kidney injury (PR-AKI) is a global health problem with substantial maternal and fetal morbidity and mortality. However, little is known about the current situation in the developing world including African countries. Africa is the poorest continent per capita, and women from Sub-Saharan Africa alone account for 66% of the estimated global maternal deaths from preventable obstetric causes.

Methods: OBJECTIVE: To review the literature on the clinical profile, maternal and renal outcomes of women with PR-AKI in the African continent.

Search strategy: Medline, ISI Web of Science, Scopus, and Cochrane library were searched in February 2022, using the MeSH terms and text key words: "pregnancy", "pregnant", "acute kidney injury", "acute renal insufficiency", "acute renal injury", "acute renal failure", and "Africa".

Selection criteria and data collection: Studies from African countries which reported maternal and renal outcomes in women with PR-AKI during pregnancy or postpartum were included. Editorials, short communications, and case reports were excluded. The study quality was assessed using the NHLBI tool. Data extraction was done using predefined data fields.

Results: A total of 167 studies were evaluated, of which 14 studies from seven African countries met the inclusion criteria. Preeclampsia, obstetric hemorrhage, and sepsis represented the main causes of PR-AKI. Maternal mortality ranged between 0 and 34.4%. Although the majority of women needed ICU admission and hemodialysis, renal recovery occurred in 53.1-90% of patients. Perinatal mortality has been reported to be 1.5-60.5% in the included studies.

Authors' conclusions: PR-AKI in Africa represents the second leading cause of AKI. Limited access to obstetric care, late referral, and late diagnosis of women with risks for PR-AKI hinder the curtailment of the problem. Provision of health care facilities with adequately trained personnel and implementation of preventive strategies will be of great value in decreasing the magnitude of the problem.

Keywords: Acute kidney injury (AKI); Africa; Pregnancy; Pregnancy-related acute kidney injury (PR-AKI).

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Conflict of interest statement

No conflict of interest has been declared by the author(s).

Figures

Fig. 1
Fig. 1
Main causes of PR-AKI in different African countries
Fig. 2
Fig. 2
PRISMA flow chart of this systematic review
Fig. 3
Fig. 3
Distribution of the 14 studies across Africa
Fig. 4
Fig. 4
Healthcare challenges facing African women in reproductive age
Fig. 5
Fig. 5
A suggested approach in an effort to improve the situation in the African setting
See this image and copyright information in PMC

References

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