Introduction
Methods
Search strategy
Study selection
Quality assessment and data extraction
Statistical analysis
Results
Study selection and quality assessment
Characteristics of included studies
Author | Year | Country | Study period | Baseline eGFR, ml/min/1.73m2 | Male (%) | Sample size | Cumulative incidence (%) | No. of incident cases | eGFR equation‡ |
---|---|---|---|---|---|---|---|---|---|
eGFR < 90 mL/min/1.73m2(n = 6) | |||||||||
Lucas G. M [18]. | 2010 | Uganda | 1994–2003 | no statement | 35.4 | 1202 | 7 | 84 | MDRD |
Monteagudo-Chu M. O [19]. | 2012 | USA | Dec.1998-Dec.2008 | eGFR≥90 | 99.6 | 230 | 43 | 99 | MDRD |
Laprise C [20]. | 2013 | Canada | Jan.2002-Mar.2012 | eGFR≥90 | 96.2 | 1043 | 26 | 271 | CKD-EPI |
Mapesi H [21]. | 2018 | Tanzania | Jan.2013-Jun.2016 | eGFR≥90 | 33.3 | 921 | 12.7 | 117 | CKD-EPI |
Ding Y [22]. | 2019 | China | Jan.2004/Dec.2014–Dec.2016 | eGFR≥90 | 58.8 | 5357 | 16.3 | 872 | MDRD |
Liu F [23]. | 2020 | China | Jan.2010/ Dec.2015-Jan.2017 | eGFR≥90 | 95.4 | 823 | 21.6 | 178 | CKD-EPI |
Decrease in eGFR > 3 mL/min/1.73m2(n = 2) | |||||||||
Scherzer R [24]. | 2012 | USA | 1997–2007 | All range | 97.7 | 10,841 | 28.4 | 3078 | MDRD |
Zachor H [25]. | 2016 | South Africa | Sep.2010-May.2013 | eGFR≥60 | 65.5 | 650 | 55.5 | 361 | CKD-EPI |
CKD or eGFR < 60 mL/min/1.73m2(n = 40) | |||||||||
Lucas G. M [26]. | 2008 | USA | 1990-Feb.2003 | eGFR > 60 | 68 | 4259 | 4.9 | 210 | MDRD |
Campbell L. J [27]. | 2009 | UK | Jan.1998-Dec2006 | eGFR≥60 | – | 1048 | 3.4 | 36 | MDRD |
Lucas G. M [18]. | 2010 | Uganda | 1994–2003 | eGFR≥60 | 35.4 | 1202 | 1 | 12 | MDRD |
Flandre P [28]. | 2011 | France | 1993–2006 | no statement | 70.3 | 7378 | 4.7 | 349 | MDRD |
Rasch M. G [29]. | 2012 | Denmark | Jan.1995-Jan.2009 | eGFR≥60 | 85.2 | 2044 | 8 | 164 | MDRD |
Rockwood N [30]. | 2012 | UK | Jun.2006-Feb.2010 | eGFR> 60 | 87 | 2115 | 18.3 | 386 | MDRD |
Kalayjian R. C [31]. | 2012 | USA | Apr.1996-Jul.2009 | eGFR≥60 | 81.3 | 3329 | 3.2 | 106 | MDRD |
Scherzer R [24]. | 2012 | USA | 1997–2007 | eGFR≥60 | 97.7 | 10,161 | 5.2 | 533 | MDRD |
Ganesan A [32] | 2013 | USA | HIV diagnosis-2010 | eGFR≥60 | 92.4 | 3360 | 3.5 | 116 | CKD-EPI |
Morlat P [33]. | 2013 | France | Jan.2004-Dec.2012 | eGFR≥60 | 74.4 | 4350 | 4.8 | 209 | MDRD |
Lucas G. M [34]. | 2013 | USA and Canada | 1996- | eGFR > 60 | 85.6 | 59,236 | 11.6 | 6878 | CKD-EPI |
Scherzer R [35]. | 2014 | USA | 1997-Jan.2011 | eGFR> 60 | 100 | 21,590 | 9.5 | 2059 | CKD-EPI |
Pujari S. N [36]. | 2014 | UK | Jan.2007-Dec.2009 | eGFR> 90 | 76.5 | 574 | 1.4 | 8 | MDRD |
Pujari S. N [36]. | 2014 | India | Jan.2007-Dec.2009 | eGFR> 90 | 75.8 | 708 | 1.6 | 11 | MDRD |
Nishijima T [37]. | 2014 | Japan | Jan.2004/Dec.2011-Dec.2013 | eGFR≥60 | 97 | 792 | 5.1 | 40 | MDRD |
Quesada P. R [38]. | 2015 | Spain | Jan.2010-Dec.2012 | eGFR> 60 | 70.1 | 451 | 14.4 | 65 | MDRD |
Estrella M. M [39]. | 2015 | USA | Mar.2003-Mar.2012 | eGFR≥60 | 100 | 333 | 9.9 | 33 | CKD-EPI |
Lapadula G [40]. | 2016 | Italy | 2002-Nov.2014 | eGFR> 90 | 69 | 6984 | 2.7 | 191 | CKD-EPI |
Nishijima T [41]. | 2016 | Japan | Jan.2004/Apr.2013-Apr.2014 | eGFR> 60 | 96 | 655 | 0.3 | 2 | CKD-EPI |
Zachor H [25]. | 2016 | South Africa | Sep.2010-May.2013 | eGFR≥60 | 65.5 | 650 | 2.3 | 15 | CKD-EPI |
Hara M [42]. | 2017 | Japan | 2008–2014 | eGFR≥60 | 90.5 | 544 | 13.2 | 72 | MDRD |
De Waal R [43]. | 2017 | South Africa | Jul.2002-Jul.2013 | no statement | 37.5 | 15,156 | 7.2 | 1085 | MDRD |
Rossi C [44]. | 2017 | Canada | Jan.2000-Dec.2012 | eGFR≥60 | 85 | 2595 | 5.8 | 150 | CKD-EPI |
Suzuki S [45]. | 2017 | Japan | Jan.2004-Dec.2013 | eGFR≥60 | 94 | 1383 | 10.8 | 150 | MDRD |
Wong C [46]. | 2017 | USA and Canada | Jan.2000-Dec.2013 | eGFR> 90 | 83.3 | 52,411 | 3.4 | 1785 | CKD-EPI |
Bouatou Y [47]. | 2018 | Switzerland | Jan.2002-Aug.2016 | eGFR≥60 | 73.7 | 5384 | 4.7 | 252 | CKD-EPI |
Cheung J [48]. | 2018 | Australia and New Zealand | Apr.2008-Mar.2016 | eGFR> 60 | 90.7 | 1924 | 4.2 | 81 | CKD-EPI |
Jones R [49]. | 2018 | UK | Jan.1996-Dec.2014 | eGFR≥60 | 39.9 | 7764 | 3 | 231 | CKD-EPI |
Joshi K [50]. | 2018 | Asian countries† | 2003-Sep.2016 | eGFR> 60 | 70.5 | 2547 | 1.5 | 37 | CKD-EPI |
Woolnough E.L. [51] | 2018 | D:A:D study | Dec.2009-Nov.2016 | eGFR≥60 | 91 | 748 | 5.0 | 37 | CKD-EPI |
Pongpirul W [52]. | 2018 | Thailand | Dec.2007-Jun.2015 | eGFR≥60 | 58.5 | 5430 | 4.2 | 229 | CKD-EPI |
Ojeh B. V [53]. | 2018 | Nigeria | Jan.2008-Dec.2011 | eGFR≥60 | 32.9 | 5273 | 3.7 | 195 | MDRD |
Mapesi H [21]. | 2018 | Tanzania | Jan.2013-Jun.2016 | eGFR≥90 | 33.3 | 921 | 4.3 | 40 | CKD-EPI |
Matłosz B [54]. | 2019 | Poland | 1994–2015 | All range | 68.9 | 267 | 19.5 | 52 | MDRD |
Bock P [55]. | 2019 | South Africa and Zambia | Jan.2014-Oct.2016 | eGFR≥60 | 32.1 | 1634 | 1.7 | 27 | MDRD |
Kabore N. F [56]. | 2019 | Burkina Faso | Jan.2007-Dec.2016 | eGFR≥60 | 28 | 3124 | 0.9 | 27 | MDRD |
Domingo P [57]. | 2019 | Spain | 2010–2014 | eGFR≥60 | 73.7 | 8512 | 2.1 | 183 | CKD-EPI |
Eaton E.F [58]. | 2019 | USA | Jan.2007-Dec. 2014 | eGFR≥60 | 84.0 | 4387 | 3.1 | 135 | CKD-EPI |
Mills A.M. [59] | 2020 | USA | Jan. 2002-Dec. 2016 | eGFR > 60 | 84.1 84.1 | 22,748 22,727 | 5.2 5.2 | 1183 1182 | MDRD CKD-EPI |
Han W.M [60]. | 2020 | Asian countries | Jan 2003-Mar. 2019 and Jan.2003- Sep.2017 | eGFR> 60 | 68.3 | 6092 | 6.4 | 391 | CKD-EPI |
eGFR < 45 mL/min/1.73m2(n = 3) | |||||||||
Kalayjian R. C [31]. | 2012 | USA | Apr.1996-Jul.2009 | eGFR≥60 | 81.3 | 3329 | 1 | 34 | MDRD |
Medapalli R. K [61]. | 2012 | USA | No statement | eGFR≥45 | 97.1 | 12,422 | 9.1 | 1136 | CKD-EPI |
Suzuki S [45]. | 2017 | Japan | Jan.2004-Dec.2013 | eGFR≥60 | 94 | 1383 | 0.8 | 11 | MDRD |
eGFR < 30 mL/min/1.73m2(n = 6) | |||||||||
Ibrahim F [13]. | 2012 | UK | Jan.1996-Dec.2008 | eGFR≥30 | 78.6 | 20,045 | 0.3 | 56 | CKD-EPI |
Kalayjian R. C [31]. | 2012 | USA | Apr.1996-Jul.2009 | eGFR≥60 | 81.3 | 3329 | 0.5 | 16 | MDRD |
Quesada P. R [38]. | 2015 | Spain | Jan.2010-Dec.2012 | eGFR≥60 | 70.1 | 451 | 1.1 | 5 | MDRD |
De Waal R [43]. | 2017 | South Africa | Jul.2002-Jul.2013 | no statement | 37.5 | 15,156 | 1.9 | 292 | MDRD |
Suzuki S [62]. | 2017 | Japan | Jan.2004-Dec.2013 | eGFR≥60 | 94 | 1383 | 0.1 | 1 | MDRD |
Mapesi H [21]. | 2018 | Tanzania | Jan.2013-Jun.2016 | eGFR≥90 | 33.3 | 921 | 2 | 18 | CKD-EPI |
>25% decrease in eGFR (
n = 7)
| |||||||||
Chaisiri K [63]. | 2010 | Thailand | Jan.2007-Oct.2009 | eGFR> 50 | 56.8 | 405 | 19.3 | 78 | MDRD |
Nishijima T [64]. | 2011 | Japan | Jan.2002-Mar.2009 | eGFR> 60 | 95.2 | 495 | 19.6 | 97 | MDRD |
Nishijima T [65]. | 2012 | Japan | Jan.2004-Mar.2009 | eGFR> 60 | 97.8 | 503 | 16.9 | 85 | MDRD |
Nishijima T [37]. | 2014 | Japan | Jan.2004/Dec.2011-Dec.2013 | eGFR≥60 | 97 | 792 | 34 | 269 | MDRD |
Koh H.M [66]. | 2016 | Malaysia | Mar. 2011-Jun. 2011 | all range | 75.5 | 440 | 15.2 | 67 | MDRD |
Nishijima T [41]. | 2016 | Japan | Jan.2004/Apr.2013-Apr.2014 | eGFR> 60 | 96 | 655 | 3.1 | 20 | CKD-EPI |
Lee J. E [67]. | 2019 | South Korea | Oct.2006-Dec.2014 | eGFR≥60 | 88 | 210 | 12.9 | 27 | CKD-EPI |
Confirmed eGFR < 60 among persons with baseline eGFR ≥ 60 or 25% decline in eGFR for persons with baseline eGFR < 60 (
n = 4)
| |||||||||
Low J. Z [68]. | 2018 | Malaysia | Jan.2009-Jul.2014 | eGFR≥60 | 89.5 | 314 | 9.6 | 30 | MDRD |
Ding Y [22]. | 2019 | China | Jan.2004/Dec.2014–Dec.2016 | All range | 58.8 | 5357 | 2.4 | 130 | MDRD |
Mocroft A [69]. | 2020 | EuroSIDA Study | Jan.2004–2018(median) | All range | 74 | 14,754 | 7.7 | 1130 | CKD-EPI |
Sutton S. S [70]. | 2020 | USA | Jan.2006-Dec.2018 | All range | 97 | 5811 | 15.3 | 889 | CKD-EPI |
Decrease in eGFR > 10 mL/min/1.73m2(n = 3) | |||||||||
Nishijima T [37]. | 2014 | Japan | Jan.2004/Dec.2011-Dec.2013 | eGFR≥60 | 97 | 792 | 77.4 | 613 | MDRD |
Nishijima T [41]. | 2016 | Japan | Jan.2004/Apr.2013-Apr.2014 | eGFR> 60 | 96 | 655 | 80.6 | 528 | CKD-EPI |
Tan Q [71]. | 2019 | China | Jul.2014-Apr.2015 | eGFR≥60 | 97 | 258 | 24.8 | 64 | CKD-EPI |
eGFR < 15 mL/min/1.73m2(n = 2) | |||||||||
Lucas G. M [34]. | 2013 | USA and Canada | 1996- | eGFR> 15 | 85.6 | 61,646 | 1.8 | 1098 | CKD-EPI |
Jones R [49]. | 2018 | UK | Jan.1996-Dec.2014 | no statement | 39.9 | 7764 | 0.8 | 65 | CKD-EPI |
Decrease in eGFR > 50% (
n = 2)
| |||||||||
Alves T. P [72]. | 2010 | USA | Jan.1998-Dec.2005 | All range | 78.8 | 2468 | 2.6 | 63 | CKD-EPI |
Horberg M [73]. | 2010 | USA | Jan.2002-Dec.2005 | No statement | 85.3 | 1674 | 3.9 | 66 | MDRD |
Decrease in eGFR > 25% to < 60 mL/min/1.73 m2(n = 2) | |||||||||
Ando M [74]. | 2011 | Japan | Jan.2008/Mar.2008-Jan.2009/Mar.2009 | eGFR> 60 | 90.5 | 623 | 2.9 | 18 | MDRD |
Lucas G. M [34]. | 2013 | USA and Canada | 1996- | eGFR> 30 | 85.6 | 61,367 | 6.4 | 3945 | CKD-EPI |
Other definitions of impaired kidney function*
| |||||||||
Tordato F [75]. | 2011 | Italy | Jan.2000–2009 | All range | 70 | 644 | 14.9 | 96 | MDRD |
Nishijima T [41]. | 2016 | Japan | Jan.2004/Apr.2013-Apr.2014 | eGFR> 60 | 96 | 655 | 6.7 | 44 | CKD-EPI |
Hara M [42]. | 2017 | Japan | 2008–2014 | All range | 90.5 | 661 | 77 | 509 | MDRD |
Tan Q [71]. | 2019 | China | Jul.2014-Apr.2015 | eGFR≥60 | 97 | 258 | 1.2 | 3 | CKD-EPI |
Dietrich L. G [76]. | 2020 | Switzerland | Two periods with only median time | eGFR≥80 | 81.3 | 3603 | 6.2 | 225 | CKD-EPI |
Liu F [23] | 2020 | China | Jan.2010/ Dec.2015-Jan.2017 | eGFR≥90 | 4.6 | 823 | 54.8 | 451 | CKD-EPI |
Kalemeera F [77]. | 2021 | Namibia | Aug.2010-Dec.2016 | eGFR≥60 | 39.6 | 6744 | 5.9 | 400 | CKD-EPI |
Different definitions and incidence of IKF
eGFR< 60 ml/min/1.73m2 and combined eGFR
Decrease in eGFR > 25%
eGFR< 30 ml/min/1.73m2
eGFR< 90 ml/min/1.73m2
Other definitions of IKF
Subgroup analysis and meta-regression analysis
Variables | No. of study | Person-year | Case | Pooled IR (95%CI) | Test for heterogeneity |
p for subgroup difference | |
---|---|---|---|---|---|---|---|
I2 (%) |
p-value | ||||||
Total | 29 | 1,346,996.15 | 17,133 | 12.50(9.13–17.11) | 99.72 | < 0.001 | |
WHO region | |||||||
African | 5 | 41,645 | 1340 | 13.21(3.73–46.84) | 99.55 | < 0.001 | 0.025 |
American | 9 | 1,052,357.45 | 13,020 | 10.05(7.65–13.2) | 99.46 | < 0.001 | |
European | 9 | 159,452.8 | 1899 | 16.79(8.84–31.88) | 99.49 | < 0.001 | |
South-East Asia | 1 | 61,497.5 | 229 | 10.39(9.13–11.83) | . | – | |
Western Pacific | 2 | 22,035 | 190 | 17.9(13.07–24.51) | 70.15 | 0.056 | |
Mixed | 3 | 10,008.4 | 455 | 7.5(3.2–17.57) | 96.89 | < 0.001 | |
Income level | |||||||
Low | 2 | 16,901 | 39 | 2.88(1.24–6.71) | 83.9 | 0.009 | < 0.001 |
Lower middle | 2 | 6322.9 | 216 | 28.08(15.61–50.53) | 85.52 | 0.006 | |
Upper middle | 2 | 40,456.1 | 1314 | 24.77(4.53–135.37) | 99.82 | < 0.001 | |
High | 20 | 1,221,818.65 | 15,109 | 13.35(9.63–18.5) | 99.69 | < 0.001 | |
Mixed | 3 | 61,497.5 | 455 | 7.5(3.2–17.57) | 96.89 | < 0.001 | |
Race†
| |||||||
Mainly white | 5 | 52,957.9 | 1058 | 25.67(10.03–65.72) | 99.56 | < 0.001 | 0.397 |
Mainly black | 8 | 111,744 | 1808 | 11.62(5.22–25.88) | 99.51 | < 0.001 | |
Mainly Asian | 5 | 91,818.9 | 847 | 9.74(5.38–17.65) | 98.47 | < 0.001 | |
Mixed | 8 | 1,033,579.45 | 12,810 | 9.91(7.28–13.48) | 99.57 | < 0.001 | |
Unknow | 3 | 56,895.9 | 610 | 12.54(8.09–19.41) | 95.93 | < 0.001 | |
Median or average age (yrs) | |||||||
< 40 | 17 | 231,407.8 | 2954 | 10.86(7.17–16.43) | 99.12 | < 0.001 | 0.019 |
≥40 | 6 | 550,014 | 9729 | 25.92(12.43–54.05) | 99.86 | < 0.001 | |
Unknow | 6 | 565,574.35 | 4450 | 8.92(7.42–10.72) | 97.08 | < 0.001 | |
Male (%) | |||||||
< 60 | 7 | 92,966 | 1598 | 11.67(4.63–29.43) | 99.51 | < 0.001 | 0.861 |
≥60 | 22 | 1,254,030.15 | 15,535 | 12.74(9.35–17.35) | 99.67 | < 0.001 | |
ART status | |||||||
ART-experienced< 70% at baseline | 7 | 834,670.35 | 10,551 | 8.71(5.82–13.03) | 99.63 | < 0.001 | < 0.001 |
ART-experienced≥70% at baseline | 11 | 176,674.8 | 1792 | 11.69(8.37–16.32) | 97.94 | < 0.001 | |
ART/TDF initiation | 10 | 312,560 | 4674 | 19.09(9.3–39.22) | 99.8 | < 0.001 | |
Unknow | 1 | 23,091 | 116 | 5.02(4.19–6.03) | . | ||
Sample size | |||||||
< 1000 | 4 | 8607.8 | 178 | 20.56(15.45–27.37) | 71.79 | 0.006 | 0.013 |
≥1000 | 25 | 1,338,388.35 | 16,955 | 11.58(8.13–16.48) | 99.78 | < 0.001 | |
eGFR calculation equation | |||||||
CKD-EPI | 11 | 691,979.4 | 5462 | 8.86(6.2–12.64) | 99.3 | < 0.001 | 0.054 |
MDRD | 18 | 655,016.75 | 11,671 | 15.41(9.97–23.82) | 99.74 | < 0.001 |