April 28, 2016
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Prediabetes increases risk for chronic kidney disease

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Patients with prediabetes are at modestly increased risk for developing chronic kidney disease, recent study findings show.

In a systematic review, Justin B. Echouffo-Tcheugui, MD, PhD, adjunct assistant professor in the Rollins School of Public Health at Emory University in Atlanta, and colleagues reviewed nine population-based cohort studies investigating relationships between fasting blood glucose levels and CKD; studies included assessment of microalbuminuria, albuminuria or proteinuria and/or decreased glomerular filtration rate. Sample sizes ranged from 2,398 to 118,924 (n = 185,452). Three studies included U.S. populations; one study included European populations; four were conducted in Asia. Follow-up ranged between 3 and 9 years (mean, 6 years), corresponding to 835,146 person-years. Eight of the studies defined impaired fasting glucose as 110 to 125 mg/dL; one study defined IFG as 100 to 125 mg/dL. Researchers estimated pooled risk ratios using a random-effects meta-analysis model.

Across eight cohort studies defining impaired fasting glucose as 110 to 125 mg/dL, the summary relative risk for CKD after adjustment for established risk factors was 1.11 (95% CI, 1.02-1.21). RR increased to 1.12 when restricting analysis to the one study that defined IFG as 100 to 125 mg/dL (95% CI, 1.02-1.21).

Researchers noted that the association between prediabetes and CKD 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. “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.” –by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.