A Systematic Review and Meta-Analysis of Mortality and Kidney Function in Uranium – Exposed Individuals

Review question / Objective: 1) In humans, how does environmental and/or occupational exposure to uranium affect the risk of mortality due to primary kidney disease compared to unexposed individuals? (2) In humans, how does environmental and/or occupational exposure to uranium affect the risk of developing kidney failure compared to unexposed individuals? Eligibility criteria: We included cohort studies that evaluate the risk of CKD/ESKD due to uranium exposure. We also included cohort studies that evaluate standardized mortality due to all-cause mortality, kidney cancer, chronic kidney disease, diabetes, and cardiovascular disease in humans with exposure to uranium. We also included cross sectional studies that evaluate renal function in humans exposed to uranium via biomarkers and hard clinical measures (such as creatinine clearance) compared to humans with low/no uranium exposure. In order to not include the same cohort multiple times in the statistical analyses, we selected studies that evaluated an outcome of interest for a given cohort for the longest follow-up period. When this was not possible (due to multiple studies using different combinations of cohorts with varying lengths of follow up), the study with the largest study population size was selected.