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Background <p>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.</p> Methods <p>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.</p> Results <p>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; <i>P</i> &lt; 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; <i>P</i> = 0.001). Urinary albumin-to-creatinine ratio increased in 21 observations (MD: 0.87; 95% CI: 0.19–1.55; <i>P</i> = 0.012). Stronger associations were observed in Asia than in Europe or the United States.</p> Conclusion <p>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.</p>

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Association between prediabetes and nephropathy: a comprehensive systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月25日

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  • Raheleh Karimi,
  • Roya Riahi,
  • Mojgan Mortazavi,
  • Setayesh Sindarreh,
  • Ashraf Aminorroaya,
  • Mohammad Reza Maracy

摘要

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.