Hepatitis C Virus Infection and Kidney Disease

Abstract

SummaryBackground 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.

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

“…A systematic review with a meta-analysis of observational studies from us had previously revealed an independent impact of HCV infection on proteinuria but not with reduced GFR in the adult general population. However, the total number of studies was small (n = 9), and many studies had cross-sectional design; 817,917 patients were enrolled [36]. Numerous and larger studies have been subsequently published including a systematic review with meta-analysis which enrolled a lower number of studies (14 vs. 23) and did not analyze the risk of proteinuria among HCV-infected patients [37].…”

Glomerular Diseases Associated With Hepatitis B and C

“…48 Recent population-based studies have shown a link between HCV infection and proteinuria. 49 Thus, both pathologic and epidemiologic studies support the high prevalence of HCV-GN of some form in HCV-infected individuals.…”

Hepatitis C and its impact on renal transplantation

“…76 Such immunocomplexes activate mesangial Tolllike receptor 3 during HCV infection, which promotes release of chemokines and cytokines, subsequently downregulating proliferation and stimu lating apoptosis of mesangial cells. 82 A high frequency of occult HCV infection was identified among patients with glomerular disease who tested negative for anti HCV antibodies and RNA, and who had not undergone kidney transplantation.…”