Key result
Higher coffee consumption linked to ~23% lower risk of adverse renal outcomes versus low intake.
Why the study?
Coffee and caffeine have favorable cardiometabolic associations, but their effects on diabetic kidney disease remain uncertain.
Does higher coffee or caffeine intake reduce the risk of diabetic nephropathy and adverse kidney outcomes in adults with diabetes?
Meta-Analysis (n=200,000)
Does higher coffee or caffeine intake reduce the risk of diabetic nephropathy and adverse kidney outcomes in adults with diabetes?
Hazard Ratio: 0.77 (95% CI 0.69–0.86)
Habitual coffee consumption is associated with a lower risk of diabetic kidney disease in observational studies, though Mendelian randomization yields mixed results suggesting potential confounding.
Introduction and Objective: Diabetic nephropathy is a leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Coffee and caffeine have favorable cardiometabolic associations, but their effects on diabetic kidney disease remain uncertain. Methods: We performed a systematic review of studies published from January 2015 through March 2025 evaluating coffee or caffeine intake in relation to diabetic nephropathy or kidney outcomes in adults with diabetes. Eligible designs included prospective cohort studies, cross-sectional analyses, meta-analyses, and Mendelian randomization (MR) studies. Primary outcomes were incident CKD (eGFR <60 mL/min/1.73 m²), accelerated eGFR decline, albuminuria, or ESRD. Adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis. Heterogeneity was assessed using I² statistics. Genetic and MR studies were synthesized qualitatively. Results: Three prospective cohort studies (total n >200,000) were eligible for quantitative synthesis of incident kidney outcomes. Higher coffee consumption was associated with a significantly lower risk of adverse renal outcomes compared with low or no intake (pooled HR 0.77, 95% CI 0.69-0.86; I² = 0%). Large cohort dose-response analyses demonstrated a 2-3% lower risk of CKD per additional daily cup of coffee. Observational studies consistently reported inverse associations between coffee or caffeine intake and albuminuria. However, MR analyses yielded mixed findings, with some suggesting neutral or increased genetic risk of diabetic nephropathy. Genotype-stratified studies indicated effect modification by caffeine-metabolism variants (CYP1A2). Conclusion: Habitual coffee consumption is associated with a lower risk of diabetic kidney disease in observational studies. Discordant genetic findings suggest possible confounding and effect modification. Further randomized and genetically informed studies are needed to clarify causality and identify subgroups most likely to benefit. Disclosure D. Savage-Lobeck: None. M. Barazi: None.
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Savage-Lobeck et al. (2026) conducted a meta-analysis in Diabetic nephropathy (n=200,000). Higher coffee consumption vs. Low or no intake was evaluated on Incident CKD (eGFR <60 mL/min/1.73 m²), accelerated eGFR decline, albuminuria, or ESRD (HR 0.77, 95% CI 0.69-0.86). Higher coffee consumption was associated with a significantly lower risk of adverse renal outcomes compared with low or no intake (pooled HR 0.77, 95% CI 0.69-0.86).
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