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The evidence-based epidemiology of HCV-associated kidney disease

Fabrizio Fabrizi1, Vivek Dixit, Paul Martin

  • 1Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Milan, Italy. fabrizi@policlinico.mi.it

The International Journal of Artificial Organs
|August 14, 2012
PubMed

Insights

Hepatitis C virus (HCV) infection is linked to chronic kidney disease (CKD). HCV increases the risk of developing kidney insufficiency and proteinuria, highlighting the need for further research.

Area of Science:

  • Nephrology
  • Virology
  • Immunology

Background:

  • Hepatitis C virus (HCV) infection is associated with various kidney lesions in native and transplanted kidneys.
  • The exact frequency of kidney disease in HCV-infected patients is unknown, but links are emerging.
  • HCV-associated nephropathy commonly presents as type I membranoproliferative glomerulonephritis, often with type II mixed cryoglobulinemia.

Purpose of the Study:

  • To investigate the association between HCV infection and chronic kidney disease (CKD).
  • To evaluate the risk of renal insufficiency and proteinuria in HCV-infected individuals.
  • To synthesize evidence from population-based studies and meta-analyses.

Main Methods:

  • Review of existing literature on HCV and kidney disease.
  • Meta-analysis of observational studies including 93,919 individuals.
  • Analysis of population-based surveys suggesting a link between HCV and renal issues.

Main Results:

  • Positive HCV serology was an independent and significant risk factor for proteinuria (adjusted RR 1.55, 95% CI 1.14-2.12, p=0.0001).
  • HCV infection is associated with an increased risk of renal insufficiency.
  • Viral and non-viral mechanisms are implicated in the pathogenesis of HCV-associated kidney disease.

Conclusions:

  • Novel information supports a definite link between HCV infection and CKD.
  • HCV infection increases the risk of developing proteinuria.
  • Prospective studies are required to understand the long-term impact of HCV on kidney function.

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