Association between prediabetes and nephropathy: a comprehensive systematic review and meta-analysis.
5 affiliations
- 1Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
- 2Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- 3Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- 4Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- 5Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. [email protected].
Abstract
Background
This study examines the association between prediabetes and nephropathy, focusing on chronic kidney disease and key indicators such as glomerular filtration rate and urinary albumin-to-creatinine ratio.Methods
A systematic review of studies published before November 2024 included 26 articles, 15 cohort studies, and 11 cross-sectional studies, covering 350,546 individuals with normal glucose tolerance and 146,547 with prediabetes. A random-effects restricted maximum likelihood model was used to assess chronic kidney disease, glomerular filtration rate, and urinary albumin-to-creatinine ratio. The risk of chronic kidney disease was reported using relative risk (RR) with 95% confidence intervals, while mean difference (MD) was used for glomerular filtration rate and urinary albumin-to-creatinine ratio. Publication bias and methodological quality were assessed using the Egger regression test and the National Heart, Lung, and Blood Institute quality assessment tools. Sensitivity was tested using a leave-one-out method.Results
Data from 19 studies showed that individuals with prediabetes had a higher risk of developing chronic kidney disease (RR: 1.53; 95% CI: 1.30-1.81; P < 0.001), rising to 1.21 (95% CI: 1.78-2.73) when all three diagnostic methods were used. Across 31 observations, glomerular filtration rate declined by (MD: - 2.85; 95% CI: - 4.57 to - 1.13; P = 0.001). Urinary albumin-to-creatinine ratio increased in 21 observations (MD: 0.87; 95% CI: 0.19-1.55; P = 0.012). Stronger associations were observed in Asia than in Europe or the United States.Conclusion
Prediabetes is linked to lower glomerular filtration rate and higher urinary albumin-to-creatinine ratio, indicating increased risk of chronic kidney disease. Early intervention may be beneficial.
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BibTeX
@article{karimi2026association,
title = {{Association between prediabetes and nephropathy: a comprehensive systematic review and meta-analysis.}},
author = {Raheleh Karimi and Roya Riahi and Mojgan Mortazavi and Setayesh Sindarreh and Ashraf Aminorroaya and Mohammad Reza Maracy},
journal = {BMC nephrology},
year = {2026},
month = jul,
doi = {10.1186/s12882-026-05212-5},
url = {https://europepmc.org/article/MED/42907738},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between prediabetes and nephropathy: a comprehensive systematic review and meta-analysis.
AU - Raheleh Karimi
AU - Roya Riahi
AU - Mojgan Mortazavi
AU - Setayesh Sindarreh
AU - Ashraf Aminorroaya
AU - Mohammad Reza Maracy
PY - 2026
DA - 2026/07/01
JO - BMC nephrology
DO - 10.1186/s12882-026-05212-5
UR - https://europepmc.org/article/MED/42907738
AB - Background This study examines the association between prediabetes and nephropathy, focusing on chronic kidney disease and key indicators such as glomerular filtration rate and urinary albumin-to-creatinine ratio.Methods A systematic review of studies published before November 2024 included 26 articles, 15 cohort studies, and 11 cross-sectional studies, covering 350,546 individuals with normal glucose tolerance and 146,547 with prediabetes. A random-effects restricted maximum likelihood model was used to assess chronic kidney disease, glomerular filtration rate, and urinary albumin-to-creatinine ratio. The risk of chronic kidney disease was reported using relative risk (RR) with 95% confidence intervals, while mean difference (MD) was used for glomerular filtration rate and urinary albumin-to-creatinine ratio. Publication bias and methodological quality were assessed using the Egger regression test and the National Heart, Lung, and Blood Institute quality assessment tools. Sensitivity was tested using a leave-one-out method.Results Data from 19 studies showed that individuals with prediabetes had a higher risk of developing chronic kidney disease (RR: 1.53; 95% CI: 1.30-1.81; P < 0.001), rising to 1.21 (95% CI: 1.78-2.73) when all three diagnostic methods were used. Across 31 observations, glomerular filtration rate declined by (MD: - 2.85; 95% CI: - 4.57 to - 1.13; P = 0.001). Urinary albumin-to-creatinine ratio increased in 21 observations (MD: 0.87; 95% CI: 0.19-1.55; P = 0.012). Stronger associations were observed in Asia than in Europe or the United States.Conclusion Prediabetes is linked to lower glomerular filtration rate and higher urinary albumin-to-creatinine ratio, indicating increased risk of chronic kidney disease. Early intervention may be beneficial.
SN - 1471-2369
ER -