Renal resistive index for early prediction of acute kidney injury in sub-Saharan Africa: a scoping review protocol.

INTRODUCTION: Acute kidney injury (AKI) is a complex, devastating condition characterised by a sudden reduction in renal function, leading to increased mortality and healthcare costs globally. Outcomes of AKI are worsened by factors such as limited access to healthcare, delayed hospital presentation and underlying comorbidities, which severely affect patients in sub-Saharan Africa. The renal resistive index (RRI) has come into view as an encouraging non-invasive imaging approach for the early prediction of AKI. However, the use of the RRI for AKI prediction in sub-Saharan Africa is poorly documented. This research aims to map and describe the evidence for using the RRI for the early detection of AKI in sub-Saharan Africa. METHODOLOGY: The Joanna Briggs Institute methodology for scoping reviews will be used for this study. It will include a comprehensive search of electronic databases, grey literature (including academic proceedings), as well as an extensive literature review of relevant journals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews will also be used as a guide. Discrepancies will be handled by consensus or by consulting a third reviewer. This evidence synthesis will explore the usefulness and accuracy of the RRI for early prediction of AKI in sub-Saharan Africa, where the patients are generally younger and have different AKI risk predictors and cardiovascular profiles compared with patients in high-income countries. Evidence of implementation and associated challenges will also be explored. These challenges may include limited access to specialised ultrasound equipment and a lack of trained healthcare providers proficient in RRI measurement and interpretation. The findings will inform future studies and be useful for healthcare providers, policymakers and patient advocates seeking sustainable strategies for preventing AKI. ETHICS AND DISSEMINATION: Ethical approval is not required for this scoping review. The findings of this review will be published in a peer-reviewed journal and presented to decision-makers, health system administrators and healthcare providers at national and international academic conferences.