Hepatitis C Virus Infection Increases the Risk of Developing Chronic Kidney Disease: A Systematic Review and Meta-Analysis
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Background and Rationale
Chronic kidney disease and hepatitis C virus are prevalent in the general population worldwide, and controversy exists about the impact of HCV infection on the development and progression of kidney disease.
A systematic review of the published medical literature was made to assess whether positive anti-HCV serologic status plays an independent impact on the development of chronic kidney disease in the adult general population. We used a random-effects model to generate a summary estimate of the relative risk of chronic kidney disease (defined by reduced glomerular filtration rate or detectable proteinuria) with HCV across the published studies. Meta-regression and stratified analysis were also conducted.
Twenty-three studies (n = 2,842,421 patients) were eligible, and separate meta-analyses were performed according to the outcome. Pooling results of longitudinal studies (n = 9; 1,947,034 unique patients) demonstrated a relationship between positive HCV serologic status and increased incidence of chronic kidney disease, the summary estimate for adjusted hazard ratio was 1.43 (95 % confidence interval 1.23; 1.63, P = 0.0001), and between-studies heterogeneity was noted (P value by Q test <0.0001). The risk of the incidence of chronic kidney disease associated with HCV, in the subset of Asian surveys, was 1.31 (95 % confidence interval 1.16; 1.45) without heterogeneity (P value by Q test = 0.6). HCV positive serology was an independent risk factor for proteinuria; adjusted odds ratio, 1.508 (95 % confidence intervals 1.19; 1.89, P = 0.0001) (n = 6 studies; 107,356 unique patients).
HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population.
KeywordsAdult population Chronic kidney disease Hepatitis C Meta-analysis Proteinuria
Angiotensin-converting enzyme inhibitor
Angiotensin receptor blocker
Adjusted hazard ratio
Adjusted odds ratio
Adjusted relative risk
Chronic kidney disease
Charlson comorbidity index
End-stage renal disease
Hepatitis C virus
Human immunodeficiency virus
International classification of diseases
Glomerular filtration rate
Ratio of true heterogeneity to total variation in observed effects
Modification of diet in renal disease
Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement
This work was supported in part by a “Project Glomerulonephritis” Grant, in memory of Pippo Neglia, by Associazione Amici del Croff-Onlus. The funders had no role in study design, data collection analysis, decision to publish, or preparation of the manuscript.
Compliance with Ethical Standards
Conflict of interest
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