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Association between prediabetes and risk of chronic kidney disease: a systematic review and meta‐analysis
Author(s) -
EchouffoTcheugui J. B.,
Narayan K. M.,
Weisman D.,
Golden S. H.,
Jaar B. G.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13113
Subject(s) - medicine , prediabetes , kidney disease , impaired fasting glucose , impaired glucose tolerance , albuminuria , renal function , diabetes mellitus , relative risk , type 2 diabetes , cohort study , cohort , endocrinology , confidence interval
Aims To assess the effect of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) on the incidence of chronic kidney disease. Methods PubMed and EMBASE were searched (for studies published up to March 2015). Effects estimated from cohort studies reporting the relationship of prediabetes to incident chronic kidney disease [kidney damage (microalbuminuria, albuminuria or proteinuria) and/or decreased glomerular filtration rate] were pooled using a random‐effects model meta‐analysis. Results Nine cohort studies with a total of 185 452, mainly Asian and white, participants were followed for a total of 835 146 person‐years. In eight cohort studies defining impaired fasting glucose as fasting glucose 6.1–6.9 mmol/l, the summary relative risk of chronic kidney disease after adjustment for established risk factors was 1.11 (95% CI 1.02–1.21). When a study defining impaired fasting glucose as fasting glucose 5.6–6.9 mmol/dl was added, the overall relative risk of chronic kidney disease was 1.12 (95% CI 1.02–1.21). Exclusion of the only study with information on impaired glucose tolerance did not change the relative risk (1.12; 95% CI 1.02–1.21). There was no evidence of publication bias ( P value for Egger test = 0.12). Conclusion Prediabetes is modestly associated with an increase in chronic kidney disease risk, but this remains to be robustly confirmed. Chronic kidney disease screening among people with prediabetes, and aggressive management of prediabetes in those with chronic kidney disease may be warranted.