Shift work and risk of chronic kidney disease: A systematic review and meta-analysis

초록

Objectives: This systematic review and meta-analysis is aimed to critically evaluate and quantify the association between shift work and chronic kidney disease (CKD). Methods: We searched PubMed, Embase, and Web of Science through May 2025 for observational studies examining shift work-including night or rotating shifts-and CKD outcomes among adults. Eligible outcomes included reduced estimated glomerular filtration rate (eGFR), proteinuria, or albuminuria. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analyses were performed where feasible. Results: Twelve studies were included in this systematic review. Most studies defined CKD as eGFR below 60 mL/ min/1.73 m2 or presence of albuminuria, although outcome definitions varied. Meta-analysis of 6 studies found that shift workers had significantly higher odds of CKD (pooled odds ratio: 1.43; 95% CI: 1.06-1.92) compared to non-shift workers. Risk of bias was moderate to low across studies. Heterogeneity was modest, and no significant publication bias was detected. Conclusions: Shift work is associated with a modestly increased risk of CKD. Circadian disruption and related metabolic disturbances may underlie this relationship. Given the widespread prevalence of shift work and the global burden of CKD, these findings support the need for targeted occupational health surveillance and preventive strategies for shift-working populations.

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