scholarly journals Burden and Determinants of Chronic Kidney Disease Among Diabetic Patients in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 42 ◽  
Author(s):  
Tadesse Tolossa ◽  
Getahun Fetensa ◽  
Bikila Regassa ◽  
Mekdes Tigistu Yilma ◽  
Merga Besho ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Random Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Special Focus ◽  
Significant Heterogeneity ◽  
Random Effects Model ◽  
Patients With Diabetes

Background: Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. The incidence of CKD is higher in low-income countries such as Ethiopia. In Ethiopia, there is no national representative evidence on the burden and determinants of CKD among patients with diabetes. Therefore, this review aimed to estimates the pooled burden and determinants of CKD among patients with diabetes.Methods: Published articles from various electronic databases such as Pub Med, Google Scholar, CINAHL, Scopes, Cochrane library, the Web of Science, and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. We included all observational studies (cross-sectional, case-control, and cohort) in the review. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests.Results: Published (297) and unpublished (2) literature were identified from several databases and digital libraries, of which twelve articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I2 = 85.2%), which suggests a random-effects model to estimate pooled burden. The analysis found that the pooled burden of CKD among patients with diabetes was 18.22% (95% CI: 15.07–21.38). Factors such as hypertension (OR = 2.65, 95%, CI: 1.38, 5.09), type of DM (OR = 0.33, 95%, CI: 0.14–0.76), and duration of DM (OR = 0.51, 95%, CI: 0.34–0.77) were found to have significant association with CKD.Conclusion: The current review revealed a higher burden of CKD among patients with diabetes in Ethiopia. The presence of hypertension, type II diabetes, and duration of diabetes for a longer duration were found to be independent determinants of CKD among patients with diabetes. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with a special focus on chronic diabetic patients.

scholarly journals Burden and determinants of chronic kidney disease among diabetic patients in Ethiopia: A systematic Review and Meta-analysis, 2020

2020 ◽  
Author(s):  
Tadesse Tolossa ◽  
Getahun Fetensa ◽  
Bikila Regassa ◽  
Mekdes Tigistu ◽  
Ginenus Fekadu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Random Effects ◽  
Digital Library ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Special Focus ◽  
Significant Heterogeneity ◽  
Random Effects Model

Abstract Background Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. Its incidence is increased at higher rate in low income countries including Ethiopia. In Ethiopia, there is no national representative evidence on burden and determinants of chronic kidney disease among diabetic patients. Therefore, this review aimed to estimates the pooled burden and determinants of chronic kidney disease among diabetic patients. Methods Published articles from various electronic databases such as Pub Med, Google scholar, CINAHL, Scopes, Cochrane library, the Web of Science and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. All observational studies that were conducted on the burden and determinants of chronic kidney disease among diabetic patients were included. Data were extracted on the Microsoft excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Results Published (163) and unpublished (2) literature were identified from several databases and digital library, of which ten articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I 2 = 84.6%), which suggests random-effects model to estimate pooled burden. The analysis found that the pooled burden of chronic kidney disease among diabetic patients was 17.55% (95%CI: 14.23–20.88). Being hypertensive patient, type II DM and staying with DM for greater than 10 years had positive significant association with chronic kidney disease. Conclusion The current review revealed a higher burden of chronic kidney diseases among diabetic patients in Ethiopia. Presence of hypertension, type of diabetes mellitus and staying with diabetes for longer duration were found to be independent determinants of chronic kidney disease among diabetic patients. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with special focus on chronic diabetic patients.

scholarly journals Association of Myocardial Fibrosis Detected by Late Gadolinium-Enhanced MRI with Clinical Outcomes of Patients with Diabetes: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zhi Yang ◽  
Rong Xu ◽  
Jia-rong Wang ◽  
Hua-yan Xu ◽  
Hang Fu ◽  
...  
Keyword(s):  
Myocardial Fibrosis ◽  
Random Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Imaging Biomarker ◽  
Diabetic Patients ◽  
Significant Heterogeneity ◽  
Cardiac Events ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract Background Prior studies demonstrated that myocardial fibrosis assessed by late gadolinium-enhanced (LGE) MRI is associated with an increased risk for major adverse cardiac and cerebrovascular events (MACCE) or major adverse cardiac events (MACE) in patients with diabetes. However, the results of these studies were controversial and limited. Therefore, we performed this meta-analysis assessing the associations of myocardial fibrosis detected by LGE with the risk of MACCE and MACE in patients with diabetes. Methods We selected studies using MEDLINE, EMBASE and Cochrane by Ovid on December 2019. Prospective and retrospective studies that assessed the associations of myocardial fibrosis detected by LGE with the risk of MACCE or MACE in patients with diabetes with a disease duration of at least 12 months. Two independent reviewers performed the data extraction using a standardized form. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated by a random-effects model. Results Eight studies with 1121 patients were included in this meta-analysis, and follow-up of patients ranged from 17 to 70 months. The prevalence of LGE in the total sample was high, occurring in 38.09%. The annualized event rates (AERs) for MACCE was 11.94% in patients with diabetes and LGE. The presence of myocardial fibrosis detected by LGE was associated with an increased risk for MACCE (HR: 2.58; 95%CI 1.42-4.71; P=0.002) and MACE (HR: 5.28; 95%CI 3.20-8.70; P=0.000) in patients with diabetes. In a subgroup meta-analysis, ischemic fibrosis detected by LGE was associated with MACCE/MACE (HR 3.75, 95%CI 2.11-6.69; P=0.000) in patients with diabetes. In diabetic patients with preserved ejection fraction, the association between myocardial fibrosis detected by LGE and MACCE/MACE remained significant (HR: 4.02; 95%CI 2.22-7.25; P=0.000). All of the meta-analyses showed no significant heterogeneity from random effects. Conclusion This study demonstrated that myocardial fibrosis detected by LGE conferred an increase in the risk of MACCE/MACE in patients with diabetes and may be an imaging biomarker for risk stratification.

scholarly journals Diagnostic value of the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations in diabetic patients: a systematic review and meta-analysis

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092595
Author(s):  
Xie Lingli ◽  
Zhang Qing ◽  
Xia Wenfang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Disease Epidemiology ◽  
Individual Level ◽  
The Individual

Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations are common for calculating estimated glomerular filtration rate (eGFR). Unlike CKD, the key pathological change of diabetic kidney disease (DKD) is glomerulosclerosis. Methods To conduct a meta-analysis of the diagnostic performance of the CKD-EPI and MDRD equations in diabetic patients, we searched PubMed, Embase and the Cochrane Library for studies comparing standard GFR (sGFR) with eGFR using these two equations. Results Thirteen studies of 7192 diabetic patients reporting data on bias or accuracy were included. At the study level, both equations underestimated eGFR. CKD-EPI was more accurate in studies with mean GFR ≥60 mL/minute/1.73 m2. At the individual level, both equations overestimated GFR by 6.38 mL/minute/1.73 m2 (95% confidence interval [CI] 2.67–10.1) and 7.65 mL/minute/1.73 m2 (95% CI 2.78–12.52), respectively, for sGFR < 90 mL/minute/1.73 m2. The CKD-EPI equation was 7.61% (95% CI 4.66–10.56) more accurate in subjects with sGFR > 90 mL/minute/1.73 m2. The CKD-EPI equation performed poorly in diabetic patients. Conclusions The CKD-EPI equation can be used to estimate GFR in patients with incipient DKD, but has drawbacks. Improved eGFR equations suitable for diabetic populations are needed.

scholarly journals Reduced Risk of Parkinson’s Disease in Users of Calcium Channel Blockers: A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Kapil Gudala ◽  
Raju Kanukula ◽  
Dipika Bansal
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Calcium Channel ◽  
Random Effects ◽  
Calcium Channel Blockers ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Channel Blockers ◽  
Random Effects Model

Aim. To pool the data currently available to determine the association between calcium channel blockers (CCBs) and risk of Parkinson’s disease (PD).Methods. Literature search in PubMed, EBSCO, and Cochrane library was undertaken through March 2014, looking for observational studies evaluating the association between CCBs use and PD. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model. Subgroup analyses, sensitivity Analysis, and cumulative meta-analysis were also performed.Results. Six studies were included in our meta-analysis according to the selection criteria, including three cohort studies and three case-control studies involving 27,67,990 subjects including 11,941 PD cases. We found CCBs use was associated with significant decreased risk of PD, compared with not using CCBs (random effects model pooled RR, 0.81 (95% CI, 0.69–0.95)); a significant heterogeneity was found between studies (P=0.031;I254.6%). Both the classes of CCB, that is, dihydropyridine calcium channel blockers (DiCCB) (0.80 (95% CI, 0.65–0.98)P=0.032) and non-DiCCB (0.70 (95% CI, 0.53–0.92)P=0.013), were found to be reducing the risk of PD.Conclusion. In our analysis, we found that CCBs use was associated with a Significantly decreased risk of PD compared with non-CCB use.

scholarly journals History of kidney stones and risk of chronic kidney disease: a meta-analysis

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2907 ◽  
Author(s):  
Weifeng Shang ◽  
Lixi Li ◽  
Yali Ren ◽  
Qiangqiang Ge ◽  
Ming Ku ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Stones ◽  
Meta Analysis ◽  
Positive Association ◽  
Significant Heterogeneity ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Subgroup Analyses ◽  
History Of

Background Although the relationship between a history of kidney stones and chronic kidney disease (CKD) has been explored in many studies, it is still far from being well understood. Thus, we conducted a meta-analysis of studies comparing rates of CKD in patients with a history of kidney stones. Methods PubMed, EMBASE, and the reference lists of relevant articles were searched to identify observational studies related to the topic. A random-effects model was used to combine the study-specific risk estimates. We explored the potential heterogeneity by subgroup analyses and meta-regression analyses. Results Seven studies were included in this meta-analysis. Pooled results suggested that a history of kidney stones was associated with an increased adjusted risk estimate for CKD [risk ratio (RR), 1.47 95% confidence interval (CI) [1.23–1.76])], with significant heterogeneity among these studies (I2 = 93.6%, P < 0.001). The observed positive association was observed in most of the subgroup analyses, whereas the association was not significant among studies from Asian countries, the mean age ≥50 years and male patients. Conclusion A history of kidney stones is associated with increased risk of CKD. Future investigations are encouraged to reveal the underlying mechanisms in the connection between kidney stones and CKD, which may point the way to more effective preventive and therapeutic measures.

scholarly journals Efficacy and Safety of Tanshinone for Chronic Kidney Disease: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yao Zhou ◽  
Shi-min Jiang ◽  
Li Li ◽  
Ying Wang ◽  
Lei Ding ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Treatment Group ◽  
Kidney Disease ◽  
Subgroup Analysis ◽  
Protein Level ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Urine Protein

Objective. To systematically evaluate the efficacy and safety of tanshinone for chronic kidney disease (CKD). Methods. Randomized controlled trials (RCTs) on the treatment of CKD using tanshinone were searched using 4 Chinese databases (China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), Wanfang, and Chinese Biology Medicine (CBM)) and 3 English databases (PubMed, Cochrane Library, and Excerpta Medica Database (Embase)). The results included data on blood urine nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR), 24 h urine protein, microalbuminuria (mALB), β2-macroglobulin (β2-MG), cystatin C (CysC), and safety events. The data were analyzed using Revman 5.3 and Stata 12.0 software. Results. Twenty-one studies were entered into this meta-analysis, which involved 1857 patients including 954 cases from the tanshinone treatment group and 903 cases from the control group. BUN levels in the tanshinone treatment group were significantly reduced compared with the control (standardized mean difference (SMD) = −0.65, 95% confidence interval (CI): −0.81 to −0.49, p<0.01). In addition, subgroup analysis indicated that tanshinone had a significant effect in reducing Scr levels at 14, 21, and 28 days. Scr levels in the tanshinone treatment group were significantly reduced compared with the control group (SMD = −1.40, 95% CI: −2.09 to −0.71, p<0.01); subgroup analysis based on treatment time also yielded the same results. GFR in the tanshinone treatment group was better than that in the control group (SMD = 0.83, 95% CI: 0.59 to 1.07, p<0.01). In terms of urine protein levels, 24 h urine protein level, mALB, and β2-MG of CKD patients were reduced to some degree compared with controls, and CysC levels in the tanshinone treatment group were also significantly reduced compared with the control group (SMD = −0.24, 95% CI: −0.44 to −0.03, p<0.05). Safety in the tanshinone treatment group did not differ significantly from that of the control group (risk ratio (RR) = 7.78, 95% CI: 0.99 to 61.05, p>0.05). Conclusion. This meta-analysis showed that tanshinone could control urine protein level in CKD patients, improve kidney function, and delay the evolution of CKD without significant side effects. However, the results were limited and should be interpreted with caution because of the low quality of the included studies. In the future, more rigorous clinical trials need to be conducted to provide sufficient and accurate evidence.

P1011ATHE SGTL-2 INHIBITORS DECREASE THE MORTALITY AND PROGRESSION OF CHRONIC KIDNEY DISEASE (CKD) IN TYPE 2 DIABETES PATIENTES. SYSTEMATIC REVIEW AND META-ANALYSIS OF THE LITERATURE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sebastian Cabrera ◽  
Ruben Torres ◽  
Leticia Elgueta ◽  
Erico Segovia ◽  
Maria Eugenia Sanhueza ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Renal Outcome ◽  
Diabetic Patients ◽  
Renal Outcomes ◽  
The Cochrane Collaboration ◽  
Age Range

Abstract Background and Aims Diabetic nephropathy is one of the main causes of chronic kidney disease (CKD) in the world. In the past years new studies using SGLT-2 inhibitors in diabetic patients have shown benefit in both mortality and progression of CKD. However, these works show heterogeneity between studies regarding the severity of CKD of patients included. All above complicates the interpretation of the benefits of SGLT-2 inhibitors. Method We did a systematic search of the literature in PUBMED, EMBASE, Cochrane CENTRAL trials database and in references of the selected studies. Terms used for the search were Canaglifozin, Dapaglifozin, Ertuglifozin, Empaglifozin, diabetes, mortality and CKD. Search included studies in all languages. We selected only randomized and controlled studies that reported mortality and relevant renal outcomes (doubling serum creatinine or decrease in eGFR&gt; 40%, need for renal replacement or renal death). We included studies until September 30, 2019. For the meta-analysis, a Mantel-Haenszel model of random effects was used. The software Review Manager, Version 5.3 The Cochrane Collaboration, 2014 was used. Results We obtained results from 142 studies, fifteen studies met the selected criteria, but only four reported mortality and renal outcomes (EMPA-REG, CANVAS, CREDENCE AND DECLARE-TIMI 58). A total of 38,721 patients (SGTL2 inhibitors n = 21,264 and control n = 17,457) were included for the analysis. The EMPA-REG study used Empaglifozin, the CANVAS and CREDENCE studies used Canaglifozin and the DECLARE-TIMI 58 used Dapaglifozin. All studies were funded by pharmaceutical laboratories.The average age range of the studies was between 62 to 67 years. The percentage of patients with eGFR &lt;60ml/min were 26%, 20%, 60% and 7% for the EMPA-REG, CANVAS, CREDENCE and DECLARE-TIMI 58 studies respectively.Mortality was lower in patients who used SGTL2 inhibitors OR 0.86 (CI 0.80-0.94) Figure 1. Renal outcomes were also lower in patients who used SGTL-2 inhibitors OR 0.69 (CI 0.60-0.78) Figure 2. We assessed whether the effect was related to the severity of the CKD taking out the work with patients with more severe CKD (CREDENCE study), the effect on mortality did not change OR 0.87 (CI 0.80-0.95) as well as renal outcome OR 0.66 (CI 0.52- 0.83). Conclusion The SGTL-2 inhibitors decrease mortality and improve renal outcomes in patients with diabetic nephropathy. These benefits remain in patients with less severe CKD.

scholarly journals Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998–2019

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Ling Liu ◽  
Yanqiu Wang ◽  
Wanjun Zhang ◽  
Weiwei Chang ◽  
Yuelong Jin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Cochrane Library ◽  
Height Ratio ◽  
Physical Measurements ◽  
Significant Difference ◽  
The Difference

Abstract Background The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. Methods Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. Results Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. Conclusion WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.

scholarly journals Nutraceutical supplements in management of pain and disability in osteoarthritis: a systematic review and meta-analysis of randomized clinical trials

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Dawood Aghamohammadi ◽  
Neda Dolatkhah ◽  
Fahimeh Bakhtiari ◽  
Fariba Eslamian ◽  
Maryam Hashemian
Keyword(s):  
Pain Intensity ◽  
Physical Function ◽  
Random Effects ◽  
Effect Size ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Womac Index ◽  
Pain Subscale

AbstractThis study designed to evaluate the effect of nutraceutical supplementation on pain intensity and physical function in patients with knee/hip OA. The MEDLINE, Web of Science, Cochrane Library, Scopus, EMBASE, Google Scholar, Science direct, and ProQuest in addition to SID, Magiran, and Iranmedex were searched up to March 2020. Records (n = 465) were screened via the PICOS criteria: participants were patients with hip or knee OA; intervention was different nutritional supplements; comparator was any comparator; the outcome was pain intensity (Visual analogue scale [VAS]) and physical function (Western Ontario and McMaster Universities Arthritis [WOMAC] index); study type was randomized controlled trials. The random effects model was used to pool the calculated effect sizes. The standardized mean difference (SMD) of the outcome changes was considered as the effect size. The random effects model was used to combine the effect sizes. Heterogeneity between studies was assessed by Cochran's (Q) and I2 statistics. A total of 42 RCTs were involved in the meta-analysis. Nutritional supplementation were found to improve total WOMAC index (SMD = − 0.23, 95% CI − 0.37 to − 0.08), WOMAC pain (SMD = − 0.36, 95% CI − 0.62 to − 0.10) and WOMAC stiffness (SMD = − 0.47, 95% CI − 0.71 to − 0.23) subscales and VAS (SMD = − 0.79, 95% CI − 1.05 to − 0.05). Results of subgroup analysis according to the supplementation duration showed that the pooled effect size in studies with < 10 months, 10–20 months and > 20 months supplementation duration were 0.05, 0.27, and 0.36, respectively for WOMAC total score, 0.14, 0.55 and 0.05, respectively for WOAMC pain subscale, 0.59, 0.47 and 0.41, respectively for WOMAC stiffness subscale, 0.05, 0.57 and 0.53, respectively for WOMAC physical function subscale and 0.65, 0.99 and 0.12, respectively for VAS pain. The result suggested that nutraceutical supplementation of patients with knee/hip OA may lead to an improvement in pain intensity and physical function.

scholarly journals Retinal Vascular Signs as Screening and Prognostic Factors for Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Current Evidence

2021 ◽  
Vol 11 (7) ◽  
pp. 665
Author(s):  
Michael Aronov ◽  
Raviv Allon ◽  
Danielle Stave ◽  
Michael Belkin ◽  
Eyal Margalit ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Current Literature ◽  
Meta Analysis ◽  
Disease Diagnosis ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Retinal Microvasculature ◽  
Retinal Microvascular Signs

Background: The substantial burden of kidney disease fosters interest in new ways of screening for early disease diagnosis, especially by non-invasive imaging. Increasing evidence for an association between retinal microvascular signs and kidney disease prompted us to investigate the relevant current literature on such an association systematically by performing a meta-analysis of our findings. Methods: We scrutinized the current literature by searching PubMed and Embase databases from for clinical studies of the association between retinal microvascular signs and prevalent or incident kidney disease. After excluding cases that did not meet our criteria, we extracted relevant data from 42 published studies (9 prospective, 32 cross-sectional, and 1 retrospective). Results: Our investigation yielded significant associations between retinal vascular changes (including retinopathy and retinal vascular diameter) and kidney dysfunction (including chronic kidney disease (CKD), end-stage renal disease (ESRD), albuminuria, and estimated glomerular filtration rate (eGFR) decline). According to our meta-analysis, retinopathy was associated with ESRD (hazard ratio (HR) 2.12 (95% confidence interval CI; 1.39–3.22)) and with CKD prevalence in the general population (odds ratio (OR) 1.31 (95% CI; 1.14–1.50)), and specifically in type 2 diabetic patients (OR 1.68 (95% CI; 1.68–2.16)). CRAE was associated with prevalent CKD (OR 1.41 (95% CI; 1.09–1.82)). Conclusions: Our findings suggest that the retinal microvasculature can provide essential data about concurrent kidney disease status and predict future risk for kidney disease development and progression.

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