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Journal Article Systematic Review Meta-Analysis Epublish 1 citation

PubMed: 39407336 DOI: 10.1186/s13643-024-02662-6

Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies.

Syst Rev 13(1):260

Authors: Silvia Awor, Felix Bongomin, Mark Mohan Kaggwa, Francis Pebalo Pebolo, Jackie Epila, Geoffrey Maxwell Malinga, Christine Oryema, Proscovia Nnamuyomba, Benard Abola, Acaye Ongwech, David Musoke

Affiliations

  • Department of Obstetrics and Gynaecology, Faculty of Medicine, Gulu University, P. O. Box 166, Gulu, Uganda.
  • Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
  • Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.
  • Department of Obstetrics and Gynaecology, Faculty of Medicine, Gulu University, P. O. Box 166, Gulu, Uganda.
  • Faculty of Education, Lira University, P.O. Box 1035, Lira, Uganda.
  • Department of Biology, Faculty of Science, Gulu University, P.O. Box 166, Gulu, Uganda.
  • Department of Chemistry, Faculty of Science, Gulu University, P.O. Box 166, Gulu, Uganda.
  • Department of Mathematics, Faculty of Science, Gulu University, P.O. Box 166, Gulu, Uganda.
  • Department of Pharmacology & Therapeutics, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.

Abstract

BACKGROUND

Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.

METHODS

The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords "liver function", "renal function", "sickle cell disease", and "Africa" on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2.

RESULTS

Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI - 2.99-20.23, I = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI - 0.16-15.80, I = 99%, p < 0.01) and alkaline phosphatase (ALP) - 2.54 (95% CI - 64.72 - 59.64, I = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine - 3.15 (95% CI - 15.02; 8.72, I=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was - 0.57 (95% CI - 3.49; 2.36, I = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89-28.68 mL/min/1.73 m, I = 87%, p < 0.01) compared to controls.

CONCLUSION

People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I) > 50%, there was substantial variation in the reported articles' results.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022346771.

MeSH

Cells, Blood, Anemia, Sickle Cell, Case-Control Studies, Transaminases, Liver, Enzymes