Meta-analysisindependent cross-checkabstract checked I-SOD-126 standard review
Pooled studies: soda-kidney link uncertain
Sugar- and artificially-sweetened beverages and the risks of chronic kidney disease: a systematic review and dose-response meta-analysis.
Overview
Lo WC et al.. J Nephrol 2021 · PMID 33502726 · DOI 10.1007/s40620-020-00957-0
A meta-analysis found a non-significant 30% higher kidney-disease risk with high sugary-drink intake, with risk rising above seven drinks per week.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Pool studies on sweetened drinks and kidney disease.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
About 25,000 people.
- What was actually found?
Higher risk estimates, not statistically certain.
- How large was the observed effect?
RR 1.30 (0.88-1.94).
- What do the results mean in everyday life?
The link is possible but uncertain.
- What are the study's limitations?
Few studies.
- What does it say about Elawady's specific claim?
Neither proves nor disproves the claim.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Cannot prove causation.
Scientific in-depth review
1. Full reference
- Authors
- Lo WC et al.
- Journal
- J Nephrol
- Year
- 2021
- Identifier
- PMID 33502726 DOI 10.1007/s40620-020-00957-0
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Taiwanese hospital, university and ministry funding (PubMed record)
2. Research question
Is SSB or ASB consumption associated with CKD risk?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and dose-response meta-analysis of observational studies (PubMed, Embase to February 2019)
- Population
Adults
- Country
International
- Period
to 20 February 2019
- Sample size
SSB: 6 studies (25,455); ASB: 3 studies (19,995)
- Inclusion and exclusion criteria
Observational studies reporting RR for CKD or impaired renal function
4. Methods and endpoints
- Exposure / intervention
SSB, ASB
- Comparator
Low intake
- Endpoints
CKD or impaired kidney function
- Statistical methods
Random effects; dose-response
5. Actual results
- Results
High vs low SSB: RR 1.30 (0.88-1.94); ASB: RR 1.40 (0.65-3.02); both non-significant. Dose-response: significantly increased CKD risk above seven servings per week (P<0.001).
- Absolute risks
not reported
- Authors' conclusion
Positive but non-significant association; more than seven servings per week should be avoided.
6. Strengths
- Dose-response analysis
7. Weaknesses
- Few, small studies
- Imprecise
- Mixed designs
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Small evidence base.
9. Assessment of the statistical interpretation
Pooled CIs include 1; the dose-response signal is suggestive only.
10. Relevance to the specific claim
Mixed for C-SOD-09: direction positive, overall not statistically significant.
11. Independent contrary findings
Heo 2024 (I-SOD-125) significant.
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Weak pooled evidence predating UK Biobank analysis.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Larger meta-analyses.
15. Linked fact checks
- Cola consumption damages the kidneys (chronic kidney disease). – Studies with mixed or unclear results