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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Association Between Hepatitis C Virus and Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Fabrizio Fabrizi1, Francesca M Donato2, Piergiorgio Messa3
1Division of Nephrology, Maggiore Hospital and IRCCS Foundation, Milano, Italy.
Insights
Hepatitis C virus (HCV) infection is linked to a higher risk of developing chronic kidney disease (CKD) in the general population. This systematic review confirms an association between HCV and increased CKD incidence and proteinuria.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- The association between Hepatitis C Virus (HCV) infection and chronic kidney disease (CKD) in the general population is not well-established.
- Understanding this link is crucial for public health and patient management.
Purpose of the Study:
- To systematically review and meta-analyze existing literature to determine if anti-HCV serologic status is associated with a higher frequency of CKD in adults.
- To quantify the relative risk of CKD in individuals with HCV infection.
Main Methods:
- A systematic review of published medical literature was conducted.
- A random-effects model was used for meta-analysis to estimate the relative risk of CKD (defined by low glomerular filtration rate or proteinuria) associated with HCV.
- Meta-regression and stratified analyses were performed.
Main Results:
- Forty eligible studies (n = 4,072,867) were included. Longitudinal studies (n = 15) showed a significant association between anti-HCV status and increased CKD incidence (adjusted HR = 1.54, P < 0.001).
- Ageing and longer follow-up duration increased CKD risk in HCV-positive individuals.
- A relationship was also observed between anti-HCV status and proteinuria (adjusted effect estimate = 1.633, P < 0.001).
Conclusions:
- A clear association exists between Hepatitis C Virus infection and an increased risk of chronic kidney disease in the general population.
- The underlying biological mechanisms driving this association require further investigation.
Introduction And Aim:
The role of hepatitis C virus infection as a risk factor for the development and progression of chronic kidney disease in the general population remains unclear.
Material And Methods:
A systematic review of the published medical literature was performed to assess whether positive anti-HCV serologic status is associated with higher frequency 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 lowered glomerular filtration rate or detectable proteinuria) with HCV across the published studies. Meta-regression and stratified analysis were also carried out.
Results:
Forty studies were eligible (n = 4,072,867 patients), and separate meta-analyses were conducted according to the outcome. Pooling results of longitudinal studies (n = 15 studies, n = 2,299,134 unique patients) demonstrated an association between positive anti-HCV serologic status and increased incidence of CKD, the summary estimate for adjusted HR with HCV across the surveys, 1.54 (95% CI, 1.26; 1.87) (P < 0.001). Between-study heterogeneity was observed (Q value by Chi-squared [χ2] test 500.3, P < 0.0001). The risk of chronic kidney disease related to HCV, in the subset of surveys from Asia was 1.45 (1.27; 1.65) (P < 0.001) (no heterogeneity). According to our meta-regression, ageing (P < 0.0001) and duration of follow-up (P < 0.0001) increased the risk of chronic kidney disease among HCV-positive subjects. We observed a relationship between anti-HCV positive serologic status and frequency of proteinuria, adjusted effect estimate of proteinuria with HCV among surveys was 1.633 (95% CI, 1,29; 2.05) (P < 0.001) (n = 10 studies; 315,404 unique patients). However, between-studies heterogeneity was noted (P value by Q test < 0.0001).
Conclusion:
An association between HCV infection and increased risk of chronic kidney disease in the general population exists. The mechanisms underlying such association are currently under active investigation.
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