Developing Chronic Kidney Disease Is a Risk Among Prediabetes Patients, Review Finds

Developing Chronic Kidney Disease Is a Risk Among Prediabetes Patients, Review Finds

Patients with prediabetes are at a modestly increased risk for developing chronic kidney disease (CKD), according to the findings of a recent systematic review. The manuscript, “Systematic Review or Meta-analysis Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis,” was published in the journal Diabetic Medicine.

End-stage renal disease and cardiovascular disease often complicate kidney disease with major public health and economic implications. However, many people with CKD remain undiagnosed and therefore do not benefit from interventions, including blood pressure and blood glucose control, that would prevent progression to end-stage renal disease and reduce the risk of cardiovascular disease events. Several risk factors associated with the occurrence of chronic kidney disease have been identified. Among those is diabetes mellitus, the leading cause of CKD in most countries, accounting for  approximately 30 to 40 percent of CKD in the U.S.

To assess the effect of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) on the incidence of CKD, Justin B. Echouffo-Tcheugui, MD, PhD, at Emory University in Atlanta, and colleagues reviewed nine population-based cohort studies with a total of 185,452 participants that assessed albuminuria, microalbuminuria, or proteinuria, and/or decreased glomerular filtration rate.

Three of the studies included populations from the United States, one study included people from Europe, and four studies were conducted on Asian patients. Participants were followed for a total of 835,146 person-years.

Eight of the reviewed studies defined impaired fasting glucose (IFG) as 110 to 125 mg/dL and one study defined IFG as 100 to 125 mg/dL. Researchers then estimated pooled risk ratios using a random-effects meta-analysis model.

Across eight cohort studies defining impaired fasting glucose as fasting glucose 6.1–6.9 mmol/l, the summary relative risk of CKD after adjustment for established risk factors was 1.11. 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.

According to the researchers, the relationship between prediabetes and kidney disease could be non-linear and not captured during short-term or immediate follow-up.

“In other words, the true (long-term) association of prediabetes and CKD may be stronger than that found in the present study,” the researchers wrote, according to a news release. “Furthermore, investigating the association of prediabetes with various stages of CKD III, IV, or V may help to disentangle this issue, which was not conducted in the studies included in the meta-analysis.”

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