Digestive Diseases and Sciences

, Volume 60, Issue 12, pp 3801–3813 | Cite as

Hepatitis C Virus Infection Increases the Risk of Developing Chronic Kidney Disease: A Systematic Review and Meta-Analysis

  • Fabrizio Fabrizi
  • Simona Verdesca
  • Piergiorgio Messa
  • Paul Martin
Original Article


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.


Adult 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


Confidence intervals




Diabetes mellitus


End-stage renal disease


Hepatocellular carcinoma


Hepatitis C virus


Human immunodeficiency virus


International classification of diseases


Glomerular filtration rate




Ratio of true heterogeneity to total variation in observed effects


Mixed cryoglobulinemia


Modification of diet in renal disease


Not available


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


Supplementary material

10620_2015_3801_MOESM1_ESM.doc (70 kb)
Supplementary material 1 (DOC 70 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Fabrizio Fabrizi
    • 1
    • 2
  • Simona Verdesca
    • 1
  • Piergiorgio Messa
    • 1
  • Paul Martin
    • 2
  1. 1.Division of Nephrology, Maggiore HospitalIRCCS FoundationMilanItaly
  2. 2.Division of HepatologyUniversity School of MedicineMiamiUSA

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