Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta‑analysis of case‑control studies
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Date
2024-10-15
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
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 evalu
ate 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 compar
ing 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.
Systematic review registration PROSPERO CRD42022346771
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,
I2 = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI − 0.16–15.80, I2 = 99%, p < 0.01) and alkaline phos
phatase (ALP) − 2.54 (95% CI − 64.72 – 59.64, I2 = 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, I2=99%, p < 0.01) with a funnel plot asym
metry 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, I2 = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95%
CI 10.89–28.68 mL/min/1.73 m2, I2 = 87%, p < 0.01) compared to controls.
Conclusion: People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates com
pared to controls in Africa. With all the heterogeneity (I2) > 50%, there was substantial variation in the reported articles’
results.
Description
Systematic review registration PROSPERO CRD42022346771
Keywords
Sickle cell, Liver function, Renal function, Systematic review, Africa
Citation
Awor, S., Bongomin, F., Kaggwa, M. M., Pebolo, F. P., Epila, J., Malinga, G. M., ... & Musoke, D. (2024). Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies. Systematic Reviews, 13(1), 260.