A systematic review and meta-analysis: Does hepatitis C virus infection predispose to the development of chronic kidney disease?
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Min Li1,*, Peiyuan Wang2,*, Chunhua Yang1, Wenguo Jiang1, Xiaodan Wei1, Xinbo Mu3, Xuri Li1, Jia Mi1 and Geng Tian1
1 Medicine and Pharmacy Research Center, Binzhou Medical University, Yantai, Shandong, China
2 Institute of Imaging, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
3 Personnel Department, Binzhou Medical University, Yantai, Shandong, China
* These authors have contributed equally to this work
Geng Tian, email:
Jia Mi, email:
Xuri Li, email:
Keywords: hepatitis C virus; chronic kidney disease; meta-analysis; effect estimate
Received: August 19, 2016 Accepted: October 14, 2016 Published: October 25, 2016
We aimed to meta-analytically assess the predisposition of hepatitis C virus (HCV) infection to the occurrence and severity of chronic kidney disease (CKD). Two authors independently searched articles and abstracted information. Odds ratio (OR) or hazard ratio (HR) along with 95% confidence interval (CI) was converged separately in 12 longitudinal (1,972,044 subjects) and 15 cross-sectional (937,607 subjects) studies. Overall effect estimate was remarkably significant in longitudinal studies (HR, 95% CI, P: 1.45, 1.23-1.71, < 0.001), in contrast to that in cross-sectional studies (OR, 95% CI, P: 1.25, 0.90-1.73, 0.188), with obvious heterogeneity (I2 > 95%). HCV infection was also associated with an 1.54-fold (95% CI, P: 1.27-1.87, < 0.001) increased risk of having prevalent proteinuria. In longitudinal studies with estimated glomerular filtration rate (eGFR) < 60, < 30 and < 15 ml/min/1.73m2, the corresponding HR was 1.39 (95% CI, P: 1.14-1.69, 0.001), 1.79 (0.91-3.51, 0.091) and 2.30 (1.26-4.19, 0.007). Further grouping the longitudinal studies by median follow-up time at 5 years revealed that the effect estimate was reinforced in long-term studies (HR, 95% CI, P: 1.86, 1.19-2.89, 0.006; I2=98.1%) relative to that in short-term studies (1.21, 1.03-1.43, 0.024; 92.0%). In conclusion, our findings demonstrate the significant risk of experiencing incident CKD after HCV infection, with the lower eGFR and longer HCV exposure time entailing a greater risk.
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