Park H, Adeyemi A, Henry L, Stepanova M, Younossi Z
University of Florida College of Pharmacy, Gainesville, FL, USA.
Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
J Viral Hepat. 2015 Nov;22(11):897-905. doi: 10.1111/jvh.12413. Epub 2015 Apr 22.
Epidemiological studies have reported conflicting results regarding hepatitis C virus (HCV) infection and the risk of chronic kidney disease (CKD). We systematically reviewed the literature to determine the risk of developing CKD in HCV-infected individuals compared to uninfected individuals. MEDLINE and PUBMED were searched to identify observational studies that had reported an association between HCV and CKD or end-stage renal disease (ESRD) through January 2015. Quantitative estimates [hazard ratio (HR) or odds ratio (OR)] and their 95% confidence intervals (CI) were extracted from each study. A random-effects meta-analysis was performed. Fourteen studies evaluating the risk of developing CKD/ESRD in HCV-infected individuals (n = 336,227) compared to uninfected controls (n = 2,665,631) were identified- nine cohort studies and five cross-sectional studies. The summary estimate indicated that individuals with HCV had a 23% greater risk of presenting with CKD compared to uninfected individuals (risk ratio = 1.23; 95% CI: 1.12-1.34). Results were similar by study type, for cohorts (HR = 1.26; 95% CI: 1.12-1.40) and cross-sectional studies (OR = 1.21; 95% CI: 1.09-1.32). Country-stratified analysis demonstrated a significantly increased risk between HCV and CKD in the Taiwanese subgroup (risk ratio = 1.28; 95% CI: 1.12-1.34) and the US subgroup (risk ratio = 1.17; 95% CI: 1.01-1.32). Egger regression revealed no evidence of publication bias. HCV infection is associated with a greater risk of developing and progression of CKD compared to uninfected controls.
关于丙型肝炎病毒（HCV）感染与慢性肾脏病（CKD）风险之间的关系，流行病学研究报告的结果相互矛盾。我们系统地回顾了文献，以确定与未感染个体相比，HCV感染个体发生CKD的风险。检索了MEDLINE和PUBMED，以查找截至2015年1月报告HCV与CKD或终末期肾病（ESRD）之间存在关联的观察性研究。从每项研究中提取定量估计值[风险比（HR）或比值比（OR）]及其95%置信区间（CI）。进行了随机效应荟萃分析。确定了14项评估HCV感染个体（n = 336,227）与未感染对照（n = 2,665,631）相比发生CKD/ESRD风险的研究——9项队列研究和5项横断面研究。汇总估计表明，与未感染个体相比，HCV感染者出现CKD的风险高23%（风险比 = 1.23；95% CI：1.12 - 1.34）。按研究类型划分，队列研究（HR = 1.26；95% CI：1.12 - 1.40）和横断面研究（OR = 1.21；95% CI：1.09 - 1.32）的结果相似。国家分层分析表明，在台湾亚组（风险比 = 1.28；95% CI：1.12 - 1.34）和美国亚组（风险比 = 1.17；95% CI：1.01 - 1.32）中，HCV与CKD之间的风险显著增加。Egger回归显示没有发表偏倚的证据。与未感染对照相比，HCV感染与发生CKD及病情进展的风险更高相关。
