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Modifiable Lifestyle Factors for Primary Prevention of CKD: A Systematic Review and Meta-Analysis.

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机构: [1]Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia [2]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden [3]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China [4]Bond University Nutrition and Dietetics Research Group, Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia [5]Nutrition Research Australia, Sydney, New South Wales, Australia [6]Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico [7]Department of Medicine, McMaster University, Hamilton, Ontario, Canada [8]Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada [9]Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Despite increasing incidence of CKD, no evidence-based lifestyle recommendations for CKD primary prevention apparently exist. To evaluate the consistency of evidence associating modifiable lifestyle factors and CKD incidence, we searched MEDLINE, Embase, CINAHL, and references from eligible studies from database inception through June 2019. We included cohort studies of adults without CKD at baseline that reported lifestyle exposures (diet, physical activity, alcohol consumption, and tobacco smoking). The primary outcome was incident CKD (eGFR<60 ml/min per 1.73 m2). Secondary outcomes included other CKD surrogate measures (RRT, GFR decline, and albuminuria). We identified 104 studies of 2,755,719 participants with generally a low risk of bias. Higher dietary potassium intake associated with significantly decreased odds of CKD (odds ratio [OR], 0.78; 95% confidence interval [95% CI], 0.65 to 0.94), as did higher vegetable intake (OR, 0.79; 95% CI, 0.70 to 0.90); higher salt intake associated with significantly increased odds of CKD (OR, 1.21; 95% CI, 1.06 to 1.38). Being physically active versus sedentary associated with lower odds of CKD (OR, 0.82; 95% CI, 0.69 to 0.98). Current and former smokers had significantly increased odds of CKD compared with never smokers (OR, 1.18; 95% CI, 1.10 to 1.27). Compared with no consumption, moderate consumption of alcohol associated with reduced risk of CKD (relative risk, 0.86; 95% CI, 0.79 to 0.93). These associations were consistent, but evidence was predominantly of low to very low certainty. Results for secondary outcomes were consistent with the primary finding. These findings identify modifiable lifestyle factors that consistently predict the incidence of CKD in the community and may inform both public health recommendations and clinical practice. Copyright © 2020 by the American Society of Nephrology.

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大类 | 1 区 医学
小类 | 1 区 泌尿学与肾脏学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 泌尿学与肾脏学
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出版当年[2019]版:
Q1 UROLOGY & NEPHROLOGY
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Q1 UROLOGY & NEPHROLOGY

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第一作者机构: [1]Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia [*1]Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, G40 Griffith Health Centre, Level 8.86, Gold Coast Campus Griffith University, Gold Coast, QLD 4222, Australia
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通讯机构: [1]Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia [2]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden [*1]Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, G40 Griffith Health Centre, Level 8.86, Gold Coast Campus Griffith University, Gold Coast, QLD 4222, Australia [*2]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 65 Solna, Sweden
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