title: Hepatitis C Virus Infection Increases the Risk of Developing Chronic Kidney Disease: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Chronic kidney disease and hepatitis C virus are prevalent in the general population worldwide, and controversy exists about the impact of HCV infection on the development and progression of kidney disease.
  
  
  METHODS
  A systematic review of the published medical literature was made to assess whether positive anti-HCV serologic status plays an independent impact on the development 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 reduced glomerular filtration rate or detectable proteinuria) with HCV across the published studies. Meta-regression and stratified analysis were also conducted.
  
  
  RESULTS
  Twenty-three studies (n = 2,842,421 patients) were eligible, and separate meta-analyses were performed according to the outcome. Pooling results of longitudinal studies (n = 9; 1,947,034 unique patients) demonstrated a relationship between positive HCV serologic status and increased incidence of chronic kidney disease, the summary estimate for adjusted hazard ratio was 1.43 (95% confidence interval 1.23; 1.63, P = 0.0001), and between-studies heterogeneity was noted (P value by Q test <0.0001). The risk of the incidence of chronic kidney disease associated with HCV, in the subset of Asian surveys, was 1.31 (95% confidence interval 1.16; 1.45) without heterogeneity (P value by Q test = 0.6). HCV positive serology was an independent risk factor for proteinuria; adjusted odds ratio, 1.508 (95% confidence intervals 1.19; 1.89, P = 0.0001) (n = 6 studies; 107,356 unique patients).
  
  
  CONCLUSIONS
  HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population.
authors.affiliation: Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Pad. Croff, via Commenda 15, 20122, Milan, Italy. fabrizi@policlinico.mi.it.|Division of Hepatology, University School of Medicine, Miami, FL, USA. fabrizi@policlinico.mi.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabrizi
authors.affiliation: Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Pad. Croff, via Commenda 15, 20122, Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Verdesca
authors.affiliation: Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Pad. Croff, via Commenda 15, 20122, Milan, Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.affiliation: Division of Hepatology, University School of Medicine, Miami, FL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
mesh_terms: D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors
keywords: Adult population; Chronic kidney disease; Hepatitis C; Meta-analysis; Proteinuria