Prevalence and progression of diabetic nephropathy in South Asian, white European and African Caribbean people with type 2 diabetes: a systematic review and meta-analysis
Author
Jadawji, ChandniCrasto, Winston
Gillies, Clare
Kar, Debasish
Davies, Melanie J.
Khunti, Kamlesh
Seidu, Samuel
Affiliation
Leicester General Hospital; University of Leicester; George Eliot Hospital, NuneatonPublication date
2019-03Subject
Diabetes
Metadata
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Aims: To conduct a systematic review and meta-analysis of published observational evidence to assess the difference in the prevalence and progression of diabetic nephropathy, and the development of end-stage renal disease (ESRD) in people from three different ethnic groups with type 2 diabetes (T2DM). Materials and methods: Relevant studies were identified in a literature search of MEDLINE, EMBASE and reference lists of relevant studies published up to May 2018. We decided a priori that there were no differences in the prevalence and progression of diabetic nephropathy, and the development of ESRD in the three ethnicities with T2DM. Pooled relative risks of microalbuminuria by ethnicity were estimated by fitting three random effects meta-analyses models. A narrative synthesis of the nephropathy progression in the studies was carried out. The review was registered in PROSPERO (CRD42018107350). Results: Thirty-two studies with data on 153 827 unique participants were eligible for inclusion in the review. The pooled prevalence ratio of microalbuminuria in South Asian compared with white European participants was 1.14 (95% confidence interval [CI] 0.99, 1.32; P = 0.065), while for African Caribbean vs South Asian participants the pooled prevalence ratio was 1.08 (95% CI 0.93, 1.24; P = 0.327). Results for renal decline were inconsistent, with preponderance towards a high rate of disease progression in South Asian compared with white participants. The estimated pooled incidence rate ratio (IRR) for ESRD was significantly higher in African Caribbean vs white European participants: 2.75 (95% CI 2.01, 3.48; P < 0.001). Conclusion: The results of this review did not show a significant link between ethnicity (South Asian, white European and African Caribbean) and the prevalence of microalbuminuria; however, the IRR for ESRD in African Caribbean compared with white European participants was significantly higher. Further research is needed to explore the potential non-albuminuric pathways of progression to ESRD.Citation
Jadawji C, Crasto W, Gillies C, Kar D, Davies MJ, Khunti K, Seidu S. Prevalence and progression of diabetic nephropathy in South Asian, white European and African Caribbean people with type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2019 Mar;21(3):658-673. doi: 10.1111/dom.13569.Type
ArticlePMID
30407709Journal
Diabetes, Obesity and MetabolismPublisher
Wiley-Blackwellae974a485f413a2113503eed53cd6c53
10.1111/dom.13569