scholarly journals Relationship between birth weight and chronic kidney disease: an integrative analysis of observational studies and causal inference through genetic approaches

2019 ◽  
Author(s):  
Xinghao Yu ◽  
Zhongshang Yuan ◽  
Haimiao Chen ◽  
Jiaji Yang ◽  
Yixin Gao ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Instrumental Variables ◽  
Observational Studies ◽  
Large Scale ◽  
Causal Effect ◽  
Meta Analysis ◽  
Likelihood Method ◽  
Inverse Association

ABSTRACTObjectiveAlthough many observational studies have shown that there was an inverse association between birth weight and chronic kidney disease (CKD) in adults, whether such association is causal remains largely unclear.MethodsWe first conducted a systematic review and meta-analysis to investigate the association between birth weight and CKD. Then using a set of valid instrumental variables for birth weight, we performed a two-sample Mendelian randomization (MR) to evaluate its causal effect on CKD based on summary association statistics available from large scale genome-wide association study (GWAS) (up to 143,677 individuals for birth weight and 118,147 individuals for CKD). We further validated the MR results with extensive sensitive analyses.ResultsThe results of meta-analysis showed that individuals with low birth weight have about 76% (95% CI 36∼126%) higher risk of CKD in late life compared with those with normal birth weight. Depending on 26 instrumental variables, the inverse variance weighted MR showed that the odds ratio per one SD increase of birth weight on CKD was estimated to be 0.91 (95% CI 0.72∼1.14, p=0.396). The similar null association between birth weight and CKD is also observed using the weighted median method and maximum likelihood method as well as the Egger regression. Such non-significant association is robust against potential instrumental outliers and pleiotropic effects.ConclusionOur study identifies an inverse association between birth weight and adult CKD in observational studies, while it is not supportive of the causal role of birth weight on CKD based on our MR analysis.

scholarly journals Associations between socioeconomic status and chronic kidney disease: a meta-analysis

2018 ◽  
Vol 72 (4) ◽  
pp. 270-279 ◽  
Author(s):  
Xiaoxi Zeng ◽  
Jing Liu ◽  
Sibei Tao ◽  
Hyokyoung G Hong ◽  
Yi Li ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Socioeconomic Status ◽  
Kidney Disease ◽  
Observational Studies ◽  
Disease Risk ◽  
Meta Analysis ◽  
Inverse Association ◽  
Lower Income ◽  
Lower Education ◽  
Stage Renal Disease

BackgroundSocioeconomic status (SES) has long been conjectured to be associated with the incidence and progression of chronic kidney disease (CKD), but few studies have examined this quantitatively. This meta-analysis aims to fill this gap.MethodsA systematic literature review was performed using Medline and EMBASE to identify observational studies on associations between SES and incidence and progression of CKD, published between 1974 and March 2017. Individual results were meta-analysed using a random effects model, in line with Meta-analysis of Observational Studies in Epidemiology guidelines.ResultsIn total, 43 articles met our inclusion criteria. CKD prevalence was associated with several indicators of SES, particularly lower income (OR 1.34, 95% CI (1.18 to 1.53), P<0.001; I2=73.0%, P=0.05); lower education (OR 1.21, 95% CI (1.11 to 1.32), P<0.001; I2=45.20%, P=0.034); and lower combined SES (OR 2.18, 95% CI (1.64 to 2.89), P<0.001; I2=0.0%, P=0.326). Lower levels of income, occupation and combined SES were also significantly associated with progression to end-stage renal disease (risk ratio (RR) 1.24, 95% CI (1.12 to 1.37), P<0.001; I2=66.6%, P=0.006; RR 1.05, 95% CI (1.01 to 1.09), P=0.012; I2=0.0%, P=0.796; and RR 1.39, 95% CI (1.09 to 1.79), P=0.009; I2=74.2%, P=0.009). Subgroup analyses generally confirmed these results, except in a few cases, such as an inverse association related to particular socioeconomic backgrounds and where results were adjusted by more disease-related risk factors.ConclusionLower income was most closely associated with prevalence and progression of CKD, and lower education was significantly associated with its prevalence. Evidence for other indicators was inconclusive.

scholarly journals Relationship between birth weight and chronic kidney disease: evidence from systematics review and two-sample Mendelian randomization analysis

2020 ◽  
Vol 29 (13) ◽  
pp. 2261-2274 ◽  
Author(s):  
Xinghao Yu ◽  
Zhongshang Yuan ◽  
Haojie Lu ◽  
Yixin Gao ◽  
Haimiao Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Low Birth Weight ◽  
Kidney Function ◽  
Large Scale ◽  
Mendelian Randomization ◽  
Negative Relationship ◽  
Sensitivity Analyses ◽  
Inverse Association

Abstract Observational studies showed an inverse association between birth weight and chronic kidney disease (CKD) in adulthood existed. However, whether such an association is causal remains fully elusive. Moreover, none of prior studies distinguished the direct fetal effect from the indirect maternal effect. Herein, we aimed to investigate the causal relationship between birth weight and CKD and to understand the relative fetal and maternal contributions. Meta-analysis (n = ~22 million) showed that low birth weight led to ~83% (95% confidence interval [CI] 37–146%) higher risk of CKD in late life. With summary statistics from large scale GWASs (n = ~300 000 for birth weight and ~481 000 for CKD), linkage disequilibrium score regression demonstrated birth weight had a negative maternal, but not fetal, genetic correlation with CKD and several other kidney-function related phenotypes. Furthermore, with multiple instruments of birth weight, Mendelian randomization showed there existed a negative fetal casual association (OR = 1.10, 95% CI 1.01–1.16) between birth weight and CKD; a negative but non-significant maternal casual association (OR = 1.09, 95% CI 0.98–1.21) was also identified. Those associations were robust against various sensitivity analyses. However, no maternal/fetal casual effects of birth weight were significant for other kidney-function related phenotypes. Overall, our study confirmed the inverse association between birth weight and CKD observed in prior studies, and further revealed the shared maternal genetic foundation between low birth weight and CKD, and the direct fetal and indirect maternal causal effects of birth weight may commonly drive this negative relationship.

Dietary acid load, kidney function and risk of Chronic Kidney Disease: A Systematic Review and Meta-analysis of Observational Studies

2019 ◽  
pp. 1-13 ◽  
Author(s):  
Manije Darooghegi Mofrad ◽  
Elnaz Daneshzad ◽  
Leila Azadbakht
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Observational Studies ◽  
Meta Analysis ◽  
Inverse Association ◽  
Urine Ph ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load

Abstract. Aim: Study findings examining the association between dietary acid load (DAL), kidney function and risk of chronic kidney disease (CKD) are inconsistent and there has been no meta-analysis on the relationship between DAL, kidney function and risk of CKD, hence we investigated this association in this paper. Methods: PubMed, ISI web of science and Scopus were searched up to January 2018 to identify all relevant articles. Effect sizes of eligible studies were pooled in random- effect model using the Der Simonian-Laird method. The I2 index was used to assess the amount of heterogeneity. Result: Twenty three studies with 200092 subjects were included. Meta-analysis of 9 observational studies showed that DAL had a positive significant association with risk of CKD (1.31; 95% CI: 1.06, 1.62; P = 0.011). Furthermore, increased DAL can decrease urine pH (−0.47; 95% CI: −0.85, −0.08; P = 0.017) significantly. Subgroup analysis could not identify the sources of heterogeneity about the association of DAL and risk of CKD. However, it showed the method of measurement was the source of heterogeneity about the association of DAL and urine pH (24 h urine pH: −0.62; 95% CI: −0.70, −0.54; P < 0.0001; Fasting urine pH: −0.08; 95% CI: −0.18, 0.02; P = 0.111). Conclusion: Our study showed that DAL can increase the risk of CKD and have an inverse association with urine pH.

scholarly journals Serum Total Bilirubin and Progression of Chronic Kidney Disease and Mortality: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 7 ◽  
Author(s):  
Jia Li ◽  
Dongwei Liu ◽  
Zhangsuo Liu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dose Response ◽  
Lower Risk ◽  
Large Scale ◽  
Protective Factor ◽  
Total Bilirubin ◽  
Meta Analysis ◽  
Serum Total Bilirubin ◽  
Physiological Range

Background: Previous studies have suggested that serum total bilirubin (STB) levels are associated with heightened chronic kidney disease (CKD) and mortality in both the general population and nephropathy patients. However, these results remain inconsistent. The aim of our study was to investigate whether STB was a predictor for progression of CKD and mortality by meta-analysis.Methods: We performed a systematic literature search in PubMed, Web of Science, MEDLINE, EMBASE, Google Scholar, and Cochrane Library's database up to June 30, 2019. Pooled risk ratios (RR) and corresponding 95% confidence intervals (CI) were extracted for the highest vs. lowest category STB levels within the physiological range, and a random-effects model was applied to calculate the dose–response relationships. A pooled hazard ratio (HR) was used to investigate the association between STB levels and mortality in dialysis patients.Results: A total of 16 studies, wherein participants were followed from 21 months to 7 years, were eligible for inclusion in the study. For the categorized STB, 11 studies with 41,188 participants were identified and analyzed. Patients with the highest STB levels were associated with a lower risk of CKD (RR = 0.64; 95% CI 0.55–0.73) compared to those with the lowest STB levels. Furthermore, based on seven studies, a pooled RR of 0.89, 95% CI (0.80–0.99) was observed for the continuous STB levels (per 0.2 mg/dL increase). Four studies that included 51,764 participants illustrated that there was no association between STB levels and all-cause mortality (HR = 0.77; 95% CI 0.42–1.41). A prominent negative linear relationship (X2 = 14.70; P = 0.0001) was found between STB levels and risk of CKD. Subgroup analyses showed that there were no significant differences in the subgroup adjustment factor except for sample size.Conclusions: Elevated STB levels within a physiological range are associated with lower risk of CKD regardless of the study characteristics and coincide with a liner dose–response relationship. However, whether high STB levels are a protective factor against mortality remains inconclusive. Large-scale randomized controlled trails are needed to target STB levels for predicting renal outcomes.

scholarly journals Correlation Between Soluble Klotho and Vascular Calcification in Chronic Kidney Disease: A Meta-Analysis and Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
QiFeng Liu ◽  
LiXia Yu ◽  
XiaoYa Yin ◽  
JianMing Ye ◽  
ShaSha Li
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Publication Bias ◽  
Vascular Calcification ◽  
Meta Analysis ◽  
Linear Regression Analysis ◽  
Significant Heterogeneity ◽  
Multivariate Linear Regression Analysis ◽  
Inverse Association ◽  
Increased Risk

Background: The correlation between soluble Klotho (sKlotho) level and vascular calcification (VC) in patients with chronic kidney disease (CKD) remains controversial. Using meta-analysis, we aimed to address this controversy and assess the feasibility of applying sKlotho as a biomarker for VC.Methods: Medical electronic databases were thoroughly searched for eligible publications on the association between sKlotho level and VC in CKD patients. Effectors, including correlation coefficients (r), odds ratios (ORs), hazard ratio (HR) or β-values, and 95% confidence intervals (CIs) were extracted and combined according to study design or effector calculation method. Pooled effectors were generated using both random-effects models and fixed-effects models according to I2-value. Origin of heterogeneity was explored by sensitivity analysis and subgroup analysis.Results: Ten studies with 1,204 participants from a total of 1,199 publications were eligible and included in this meta-analysis. The combined correlation coefficient (r) was [−0.33 (−0.62, −0.04)] with significant heterogeneity (I2 = 89%, p &lt; 0.001) based on Spearman correlation analysis, and this significant association was also demonstrated in subgroups. There was no evidence of publication bias. The combined OR was [3.27 (1.70, 6.30)] with no evidence of heterogeneity (I2 = 0%, p = 0.48) when sKlotho was treated as a categorical variable or [1.05 (1.01, 1.09)] with moderate heterogeneity (I2 = 63%, p = 0.10) when sKlotho was treated as a continuous variable based on multivariate logistic regression. No significant association was observed and the pooled OR was [0.29 (0.01, 11.15)] with high heterogeneity (I2 = 96%, p &lt; 0.001) according to multivariate linear regression analysis. There was an inverse association between sKlotho and parathyroid hormone levels. The combined coefficient (r) was [−0.20 (−0.40, −0.01)] with significant heterogeneity (I2 = 86%, p &lt; 0.001), and without obvious publication bias. No significant association was found between sKlotho and calcium or phosphate levels.Conclusion: There exists a significant association between decreased sKlotho level and increased risk of VC in CKD patients. This raises the possibility of applying sKlotho as a biomarker for VC in CKD populations. Large, prospective, well-designed studies or interventional clinical trials are required to validate our findings.

Age-Related Macular Degeneration in Chronic Kidney Disease: A Meta-Analysis of Observational Studies

2018 ◽  
Vol 48 (4) ◽  
pp. 278-291 ◽  
Author(s):  
Yi-Ju Chen ◽  
Ling Yeung ◽  
Chi-Chin Sun ◽  
Chien-Chieh Huang ◽  
Kuo-Su Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Macular Degeneration ◽  
Observational Studies ◽  
Meta Analysis ◽  
Positive Association ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Statistical Heterogeneity ◽  
Risk Ratios

Background: Age-related macular degeneration (AMD) is an important cause of blindness in aged people. Chronic kidney disease (CKD) was reported to be associated with a higher risk of AMD. However, supporting evidence was inconsistent between studies. This work intends to examine whether a positive association exists between CKD and AMD by systematic review and meta-analysis. Methods: A systematic search of electronic databases (Medline, PubMed, Cochrane and EMBASE) and reference lists on June 2017. The key inclusion criteria were controlled trials that investigated the relationship between AMD and CKD. The outcome measures included risk ratios and/or occurrence rates of AMD in CKD vs. non-CKD population. Data were pooled according to the type of AMD by random effect model. Results: Twelve observational studies (3 cohorts, 2 case controls, and 7 cross-sectionals) with a total 335,601 participants were included. Eleven studies reported risk ratios and 9 reported occurrence rates. Pooled prevalence for early, advanced, and any AMD were all higher in the CKD population than in the non-CKD population. The pooled multivariate adjusted OR of CKD vs. non-CKD was 1.49 (95% CI 1.11–2.02) for early, 1.55 (95% CI 1.05–2.27) for exudative, 1.58 (95% CI 1.12–2.23) for advanced, and 1.35 (95% CI 1.05–1.73) for any AMD. However, high statistical heterogeneity and methodological diversity existed. Moreover, results were inconsistent between different study designs. Conclusions: The overall results support a positive association between CKD and AMD, although some limitations exist. Given the risk that AMD is increased in CKD, regular eye screenings for the CKD population is recommended for an early detection and intervention.

scholarly journals Improvements in Fatigue at Higher Achieved Hemoglobin Levels Among Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Murilo Guedes ◽  
Camila R. Guetter ◽  
Lucas HO Erbano ◽  
Andre G. Palone ◽  
Jarcy Zee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Studies ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Related Quality ◽  
The Impact ◽  
Physical Hrqol ◽  
Anemia Treatment

Abstract Background: The impact anemia treatment with erythropoietin stimulating agents (ESA) on health-related quality of life (HRQOL) in chronic kidney disease (CKD) patients is controversial, particularly regarding optimal hemoglobin (Hb) target ranges.Methods: We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCT) with ESA to estimate the effect of different Hb ranges on physical HRQOL and functionality. We searched PubMed, EMBASE, CENTRAL, PEDro, PsycINFO and Web of Science databases, until May 2019Two authors independently extracted data from studies.We included observational and RCTs that enrolled CKD patients undergoing anemia treatment with ESA with different achieved Hb levels among groups. We excluded studies with achieved Hb < 9 g/dL. For the meta-analysis, we included RCTs with control groups achieving Hb 10-11.5 g/dL and active groups with Hb >11.5 g/dL. We analyzed the standardized mean difference (SMD) between groups for physical HRQOL.Results: Among 8,171 studies, fifteen RCTs and five observational studies were included for the systematic review. We performed the meta-analysis in a subset of eleven eligible RCTs. For physical role and physical function, SMDs were 0.0875 [CI:-0.0025 – 0.178] and 0.08 [CI: -0.03 – 0.19], respectively. For fatigue, SMD was 0.16 [0.09 - 0.24]. Subgroup analysis showed that trials with greater achieved Hb had greater pooled effects sizes — 0.21 [0.07 - 0.36] for Hb > 13 g/dL vs. 0.09 [0.02 - 0.16] for Hb 11.5-13 g/dL. Proportion of older and long-term diabetic patients across studies were associated with lower effect sizes.Conclusion: Achieved hemoglobin higher than currently recommended targets is associated with small but clinically significant improvement in fatigue. Younger and non-diabetic patients may experience more pronounced benefits of higher Hb levels after treatment with ESAs.

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