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Review
. 2012 Apr;7(4):549-57.
doi: 10.2215/CJN.06920711. Epub 2012 Mar 8.

Hepatitis C virus infection and kidney disease: a meta-analysis

Fabrizio Fabrizi  1 , Paul Martin, Vivek Dixit, Piergiorgio Messa
Affiliations
Review

Hepatitis C virus infection and kidney disease: a meta-analysis

Fabrizio Fabrizi et al. Clin J Am Soc Nephrol. 2012 Apr.

Abstract

Background and objectives: Hepatitis C virus (HCV) infection and kidney disease are both highly prevalent diseases. The association between HCV and GN has been supported by previous research but little is known about the relationship between HCV and kidney disease.

Design, setting, participants, & measurements: A systematic review of the published medical literature was conducted to determine if HCV is associated with increased likelihood of kidney disease in the general population. A random-effects model was used to generate a summary estimate of the relative risk for kidney disease, defined as an estimated GFR <60 ml/min per 1.73 m(2) or proteinuria, with HCV across the published studies.

Results: Nine clinical studies (817,917 unique individuals) were identified. Pooling of study results demonstrated the absence of a relationship between HCV seropositive status and reduced estimated GFR (adjusted relative risk, 1.12; 95% confidence interval, 0.91, 1.38; P=0.28) according to the random-effects model. HCV seropositive serology was an independent and significant risk factor for proteinuria (defined by urine dipstick test or spot urine albumin/creatinine ratio) in the general population, with a summary estimate for adjusted relative risk of 1.47 (95% confidence interval, 1.12, 1.94; P=0.006). Significant heterogeneity was observed between studies (Ri=0.82; P value by Q test, <0.001).

Conclusions: This meta-analysis shows that HCV is independently associated with proteinuria but not with reduced GFR in the general population. Substantial heterogeneity occurred.

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Figures

Figure 1.
Figure 1.
Flow diagram of studies of hepatitis C virus–related kidney disease considered for inclusion.
Figure 2.
Figure 2.
Estimated relative risks and 95% confidence intervals for each study. The vertical line represents the pooled adjusted relative risk of reduced estimated GFR (random-effects model) according to positive results for anti-hepatitis C virus serology. Adjusted relative risk, 1.12; 95% confidence interval, 0.91, 1.38 (P =0.29). Heterogeneity statistics: Tau square=0.10; Ri=0.98; coefficient of variation between=4.35. Asymptotic tests: Chi square Q value=371.32; df=9; P<0.001. Bootstrap tests: Tau square boot=significant (α=0.05). Ri, proportion of total variance due to between-study variance.
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