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Meta-Analysis
. 2024 Oct 9;14(1):84.
doi: 10.1038/s41387-024-00342-x.

Association between early exposure to famine and risk of renal impairment in adulthood: a systematic review and meta-analysis

Affiliations
Meta-Analysis

Association between early exposure to famine and risk of renal impairment in adulthood: a systematic review and meta-analysis

Mengting Huang et al. Nutr Diabetes. .

Abstract

Malnutrition early in life increases the later-life risk of noncommunicable diseases, and previous epidemiologic studies have found a link between famine and renal impairment, but no consensus has been reached. This meta-analysis and systematic review were conducted to assess the correlation between early-life famine exposure and the risk of developing renal impairment. Search in Embase, Scopus, Web of Science, PubMed, and Cochrane using keywords that report the correlation between early famine exposure and renal function indicators. RevMan and Stata software were used for data analysis. This meta-analysis contained twelve observational studies. The findings demonstrated a link between prenatal famine exposure and a higher risk of developing chronic kidney disease (CKD) (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.25, 2.39), a decreased estimated glomerular filtration rate (eGFR) (mean difference (MD) = -10.05, 95% CI: -11.64, -8.46), and increased serum creatinine (Scr) (MD = 0.02, 95% CI: 0.01, 0.03) compared to unexposed individuals. Famine exposure in childhood was associated with decreased eGFR (MD = -9.43, 95% CI: -12.01, -6.84) and increased Scr (MD = 0.03, 95% CI: 0.01, 0.04), but not with CKD (OR = 0.980, 95% CI: 0.53, 1.81). Famine exposure in adolescence and adulthood was associated with decreased eGFR (MD = -20.73, 95% CI: -22.40, -19.06). Evidence certainty was deemed to be of low or extremely low quality. Famine exposure early in life could pose a greater risk of developing renal impairment in adulthood, but this outcome may be driven by uncontrolled age differences between famine-births and post-famine-births (unexposed).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The literature search and study selection process.
Fig. 2
Fig. 2
Forest plot of fetal exposure to famine associated with risk of developing CKD in adulthood.
Fig. 3
Fig. 3
Forest plot of the associations between fetal exposure to famine and eGFR.
Fig. 4
Fig. 4
Forest plot of the associations between fetal exposure to famine and Scr.
Fig. 5
Fig. 5
Forest plot of childhood exposure to famine associated with risk of developing CKD in adulthood.
Fig. 6
Fig. 6
Forest plot of the associations between childhood exposure to famine and eGFR.
Fig. 7
Fig. 7
Forest plot of the associations between childhood exposure to famine and Scr.
Fig. 8
Fig. 8
Forest plot of the association between adolescence/adult exposure to famine and eGFR.

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