https://scholars.lib.ntu.edu.tw/handle/123456789/532503
標題: | Risk factors for development and progression of chronic kidney disease: A systematic review and exploratory meta-analysis | 作者: | Tsai W.-C. Wu H.-Y. Peng Y.-S. Ko M.-J. MING-SHIOU WU KUAN-YU HUNG KWAN-DUN WU TZONG-SHINN CHU KUO-LIONG CHIEN |
公開日期: | 2016 | 出版社: | Lippincott Williams and Wilkins | 卷: | 95 | 期: | 11 | 起(迄)頁: | e3013 | 來源出版物: | Medicine (United States) | 摘要: | The risk factors influencing the natural course of chronic kidney disease (CKD) are complex and heterogeneous, and few systematic reviews to date have focused on this issue. The aim of the study is to identify the risk factors for disease development and progression in each stage of CKD. We conducted electronic literature searches of PubMed, MEDLINE, Scopus, and the Cochrane Library up to October 15, 2012, for observational studies evaluating the risk factors on the development or progression of CKD. Eligible studies should have collected repeated information that could evaluate changes in renal function. Extracted information from all the included studies was synthesized narratively. Quality assessments were performed using the Newcastle-Ottawa Scale. An exploratory random-effects metaanalysis was performed where feasible to pool effect sizes across studies for a specific risk factor in a specific outcome. We identified 38 cohort studies and 2 case-control studies from 40 articles, with a total of 318,898 participants from 14 countries. The follow-up duration ranged from 1.5 to 16 years. The majority of the included studies were of high quality. The baseline CKD stages of the included studies ranged from normal to later stages, and only 19 studies could be classified into a specific range of CKD stages during follow-up. Three risk factors from studies of the same baseline and follow-up CKD stages were eligible for the exploratory meta-analysis, including male sex, substantial proteinuria, and diabetes. The hazard ratios for the progression from CKD stages 3-5 to end-stage renal disease (ESRD) were 1.37 (95% confidence interval 1.17-1.62), 1.64 (1.01-2.66), and 1.16 (0.98-1.38) for male sex, substantial proteinuria, and diabetes, respectively. In conclusion, our analyses comprehensively summarize the initiating and perpetuating factors for CKD. Male sex and substantial proteinuria are significant perpetuating factors for the progression from late stage CKD to ESRD, and diabetes may play a minor role for the outcome of ESRD among patients with later stages of CKD. Copyright ? 2016 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962028695&doi=10.1097%2fMD.0000000000003013&partnerID=40&md5=4f04a74166757cd615776a962d497181 https://scholars.lib.ntu.edu.tw/handle/123456789/532503 |
ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000003013 | SDG/關鍵字: | Article; chronic kidney disease; clinical assessment tool; diabetes mellitus; disease course; effect size; end stage renal disease; feasibility study; follow up; hazard ratio; human; kidney function; meta analysis; Newcastle Ottawa Scale; outcome assessment; priority journal; proteinuria; quality control; risk factor; systematic review; Diabetic Nephropathies; proteinuria; Renal Insufficiency, Chronic; Diabetic Nephropathies; Disease Progression; Humans; Proteinuria; Renal Insufficiency, Chronic; Risk Factors |
顯示於: | 醫學系 |
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