Causal insights into major risk factors for diabetic kidney disease: a comprehensive meta-analysis and Mendelian randomization study

作者：Yucong Zhou, Yahong Liu, Liang Wu, Yucai Zhang, Huixin Wen, Jiangwei Hu, Zhenxia Huo, Shaoqing Ju, Rubin Sheng · 发表于：Renal Failure · 年份：2025 · DOI：10.1080/0886022x.2025.2468741 · 被引用次数：12 · 研究领域：Genetic Associations and Epidemiology、Chronic Kidney Disease and Diabetes、Renin-Angiotensin System Studies

Background This study aims to identify major risk factors for diabetic kidney disease (DKD) and examine their causal relationships using meta-analysis and Mendelian randomization.Materials and Methods This study reviewed diabetic nephropathy literature up to September 2024, evaluating quality with NOS, AMSTAR 2, and JBI. It analyzed heterogeneity using the Baujat plot and leave-one-out method, and conducted meta-analysis with fixed- or random-effects models based on I2. Publication bias was assessed with a funnel plot and Egger’s test. Mendelian randomization using GWAS SNPs explored causal links through IVW, MR-Egger, weighted median, and weighted mode, while pleiotropy and heterogeneity were checked with the MR-Egger intercept and Cochran’s Q.Results Meta-analysis identified several significant risk factors for DKD, including hypertension (relative risk [RR] = 6.33), comorbidities (RR = 4.96), poor glycemic control (RR = 3.27), non-adherence to treatment (RR = 3.30), an unhealthy diet (RR = 5.96), physical inactivity (RR = 5.60), and hyperuricemia (RR = 5.24). MR analysis further confirmed a causal relationship between high carbohydrate intake (odds ratio [OR] = 1.393, p = 0.043) and increased DKD risk, while vegetable consumption (OR = 0.816, p = 0.011) was identified as a protective factor. These findings reinforce the critical role of dietary and lifestyle interventions in DKD prevention.Conclusions By integrating meta-analysis with Mendelian randomization, this study pr...