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HCV increases chronic kidney disease risk

Patients with hepatitis C virus infection had a greater risk for developing chronic kidney disease compared with people without the infection, according to findings published in the Journal of Viral Hepatitis.

“There is increasing evidence that suggests an association between HCV and glomerulonephritis,” the researchers wrote. “However, it is not clear what impact chronic HCV infection may have on the development and progression of [chronic kidney disease]. …  Recently, high incidence and prevalence of [chronic kidney disease] in HCV-infected patients have been reported. By contrast, several other studies have not found an increased risk of [chronic kidney disease] among HCV infected individuals.”

To investigate chronic kidney disease (CKD) risk, the researchers systematically reviewed 14 observational studies taken from the MEDLINE and PubMed databases that reported an association between HCV and CKD or end-stage renal disease patients with HCV and compared them with people without HCV.

These studies, of which nine were cohort and five cross-sectional, compared 336,227 patients with HCV with 2,665,631 controls without HCV from 1996 to January 2015.

“The purpose of the present meta-analysis was to build on past studies to help determine if there is or not an increased risk of developing and or having a progression of CKD in HCV-infected compared to uninfected individuals.”

Overall, analyses showed that patients with HCV had a 23% higher risk of presenting with CKD compared with those without HCV (risk ratio [RR] = 1.23; 95% CI, 1.12-1.34). The results were similar between the cohort studies (HR = 1.26; 95% CI, 1.12-1.4) and cross-sectional studies (OR = 1.21; 95% CI, 1.09-1.32).

A country-stratified analysis further showed an increased risk between HCV and CKD in a Taiwanese subgroup (RR = 1.28; 95% CI, 1.12-1.34) and a U.S. subgroup (RR = 1.17; 95% CI, 1.01-1.32). In addition, Egger regression analysis showed no evidence of publication bias.

“This meta-analysis of observational studies demonstrated a significantly increased risk of developing and/or progression of CKD in HCV-infected individuals compared to uninfected individuals,” the researchers wrote. “Our finding supports the systemic nature of HCV infection with both hepatic and extrahepatic manifestations.”

The researchers concluded: “Further research is needed to evaluate the clinical and economic impact of HCV on the development and progression of CKD.”

Disclosures: Park reports consulting for Gilead Sciences. Please see the study for a full list of all other authors’ relevant financial disclosures.