Novel information supports a definite link between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) in the general population. HCV is associated with a large spectrum of histopathological lesions in both native and transplanted kidneys. Kidney disease is probably uncommon in HCV-infected patients even if its exact frequency remains unknown. The most common HCV-associated nephropathy is type I membranoproliferative glomerulonephritis, usually in the context of type II mixed cryoglobulinemia. Controversial information exists on the relationship between positive HCV serology and CKD but several surveys at population-based level suggest that infection with HCV per se is associated with an increased risk of having or developing renal insufficiency or proteinuria. According to a novel meta-analysis of observational studies (4 clinical studies, 93,919 unique individuals), positive HCV serology was an independent and significant risk factor for proteinuria; the summary estimate for adjusted relative risk is 1.55 with a 95% confidence interval (CI) of 1.14; 2.12, p = 0.0001 (random-effects model). The mechanisms of these associations appear complex, but both viral and non-viral processes have been implicated. Prospective studies are needed to fully characterize the exact impact of chronic HCV infection on kidney function trajectories over time.
The evidence-based epidemiology of HCV-associated kidney disease / F. Fabrizi, V. Dixit, P. Martin, P. Messa. - In: INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS. - ISSN 0391-3988. - 35:9(2012 Sep), pp. 621-628. [10.5301/IJAO.2012.9448]
The evidence-based epidemiology of HCV-associated kidney disease
P. MessaUltimo
2012
Abstract
Novel information supports a definite link between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) in the general population. HCV is associated with a large spectrum of histopathological lesions in both native and transplanted kidneys. Kidney disease is probably uncommon in HCV-infected patients even if its exact frequency remains unknown. The most common HCV-associated nephropathy is type I membranoproliferative glomerulonephritis, usually in the context of type II mixed cryoglobulinemia. Controversial information exists on the relationship between positive HCV serology and CKD but several surveys at population-based level suggest that infection with HCV per se is associated with an increased risk of having or developing renal insufficiency or proteinuria. According to a novel meta-analysis of observational studies (4 clinical studies, 93,919 unique individuals), positive HCV serology was an independent and significant risk factor for proteinuria; the summary estimate for adjusted relative risk is 1.55 with a 95% confidence interval (CI) of 1.14; 2.12, p = 0.0001 (random-effects model). The mechanisms of these associations appear complex, but both viral and non-viral processes have been implicated. Prospective studies are needed to fully characterize the exact impact of chronic HCV infection on kidney function trajectories over time.Pubblicazioni consigliate
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