{"title":"系统回顾与荟萃分析显示丙型肝炎病毒感染与蛋白尿有关","authors":"","doi":"10.1016/j.nefro.2024.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and aim</h3><p>Hepatitis C virus infection and chronic kidney disease are major public health issues all over the world. It has been suggested a role of HCV as a risk factor for the development and progression of chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) in the general population but conflicting findings have been given.</p></div><div><h3>Material and methods</h3><p>A systematic review of the published medical literature was conducted to assess whether positive HCV serologic status is associated with greater rate of proteinuria in the adult general population. We used a random-effect model to generate a summary estimate of the relative risk of proteinuria with HCV across the published studies.</p></div><div><h3>Results</h3><p>We identified 23 studies (<em>n</em> <!-->=<!--> <!-->198,967 unique patients) and performed separate meta-analyses according to the study design. Overall effect estimate was significant in cross-sectional (OR, 1.47, 95%CI, 1.3; 1.66) (<em>P</em> <!--><<!--> <!-->0.001) and obvious between-study heterogeneity was observed (<em>Q</em> value by Chi-squared [<em>χ</em><sup>2</sup>] test 27.3, <em>P</em> <!-->=<!--> <!-->0.02). The risk of proteinuria after exposure to HCV was also consistent among longitudinal studies (HR, 1.79, 95% CI, 1.17; 2.74) (<em>P</em> <!--><<!--> <!-->0.001) and between-study heterogeneity occurred (<em>Q</em> value, 27.82 by <em>X</em><sup>2</sup> test, <em>P</em> <!-->=<!--> <!-->0.0001). Stratified analysis did not report heterogeneity in several comparisons-pooling studies based on urine protein/creatinine ratio (UACR) showed that the adjusted OR with HCV was 1.64 (95% CI, 1.41; 1.91, <em>P</em> <!--><<!--> <!-->0.001) without heterogeneity (<em>Q</em> value by Chi-squared [<em>χ</em><sup>2</sup>] test 9.98, <em>P</em> <!-->=<!--> <!-->NS). Meta-regression recorded a link between greater prevalence of proteinuria in males with HCV exposure (<em>P</em> <!-->=<!--> <!-->0.03). Studies based on univariate analysis (<em>n</em> <!-->=<!--> <!-->6, <em>n</em> <!-->=<!--> <!-->72, 551 unique patients) gave similar results, pooled OR 1.54 (95% CI, 1.08; 2.19) (<em>P</em> <!-->=<!--> <!-->0.0001).</p></div><div><h3>Conclusions</h3><p>An important relationship between HCV infection and higher risk of proteinuria in the general population exists. Research aimed to understand the biological mechanisms underlying such association is under way. We encourage to screen all patients with HCV exposure for proteinuria.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 4","pages":"Pages 486-495"},"PeriodicalIF":2.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021169952400002X/pdfft?md5=cb7687c6d17c6e9285a9c8d1fbdef5ce&pid=1-s2.0-S021169952400002X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Hepatitis C virus infection is associated with proteinuria according to a systematic review with meta-analysis\",\"authors\":\"\",\"doi\":\"10.1016/j.nefro.2024.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction and aim</h3><p>Hepatitis C virus infection and chronic kidney disease are major public health issues all over the world. It has been suggested a role of HCV as a risk factor for the development and progression of chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) in the general population but conflicting findings have been given.</p></div><div><h3>Material and methods</h3><p>A systematic review of the published medical literature was conducted to assess whether positive HCV serologic status is associated with greater rate of proteinuria in the adult general population. We used a random-effect model to generate a summary estimate of the relative risk of proteinuria with HCV across the published studies.</p></div><div><h3>Results</h3><p>We identified 23 studies (<em>n</em> <!-->=<!--> <!-->198,967 unique patients) and performed separate meta-analyses according to the study design. Overall effect estimate was significant in cross-sectional (OR, 1.47, 95%CI, 1.3; 1.66) (<em>P</em> <!--><<!--> <!-->0.001) and obvious between-study heterogeneity was observed (<em>Q</em> value by Chi-squared [<em>χ</em><sup>2</sup>] test 27.3, <em>P</em> <!-->=<!--> <!-->0.02). The risk of proteinuria after exposure to HCV was also consistent among longitudinal studies (HR, 1.79, 95% CI, 1.17; 2.74) (<em>P</em> <!--><<!--> <!-->0.001) and between-study heterogeneity occurred (<em>Q</em> value, 27.82 by <em>X</em><sup>2</sup> test, <em>P</em> <!-->=<!--> <!-->0.0001). Stratified analysis did not report heterogeneity in several comparisons-pooling studies based on urine protein/creatinine ratio (UACR) showed that the adjusted OR with HCV was 1.64 (95% CI, 1.41; 1.91, <em>P</em> <!--><<!--> <!-->0.001) without heterogeneity (<em>Q</em> value by Chi-squared [<em>χ</em><sup>2</sup>] test 9.98, <em>P</em> <!-->=<!--> <!-->NS). Meta-regression recorded a link between greater prevalence of proteinuria in males with HCV exposure (<em>P</em> <!-->=<!--> <!-->0.03). Studies based on univariate analysis (<em>n</em> <!-->=<!--> <!-->6, <em>n</em> <!-->=<!--> <!-->72, 551 unique patients) gave similar results, pooled OR 1.54 (95% CI, 1.08; 2.19) (<em>P</em> <!-->=<!--> <!-->0.0001).</p></div><div><h3>Conclusions</h3><p>An important relationship between HCV infection and higher risk of proteinuria in the general population exists. Research aimed to understand the biological mechanisms underlying such association is under way. We encourage to screen all patients with HCV exposure for proteinuria.</p></div>\",\"PeriodicalId\":18997,\"journal\":{\"name\":\"Nefrologia\",\"volume\":\"44 4\",\"pages\":\"Pages 486-495\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S021169952400002X/pdfft?md5=cb7687c6d17c6e9285a9c8d1fbdef5ce&pid=1-s2.0-S021169952400002X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nefrologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S021169952400002X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nefrologia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S021169952400002X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Hepatitis C virus infection is associated with proteinuria according to a systematic review with meta-analysis
Introduction and aim
Hepatitis C virus infection and chronic kidney disease are major public health issues all over the world. It has been suggested a role of HCV as a risk factor for the development and progression of chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) in the general population but conflicting findings have been given.
Material and methods
A systematic review of the published medical literature was conducted to assess whether positive HCV serologic status is associated with greater rate of proteinuria in the adult general population. We used a random-effect model to generate a summary estimate of the relative risk of proteinuria with HCV across the published studies.
Results
We identified 23 studies (n = 198,967 unique patients) and performed separate meta-analyses according to the study design. Overall effect estimate was significant in cross-sectional (OR, 1.47, 95%CI, 1.3; 1.66) (P < 0.001) and obvious between-study heterogeneity was observed (Q value by Chi-squared [χ2] test 27.3, P = 0.02). The risk of proteinuria after exposure to HCV was also consistent among longitudinal studies (HR, 1.79, 95% CI, 1.17; 2.74) (P < 0.001) and between-study heterogeneity occurred (Q value, 27.82 by X2 test, P = 0.0001). Stratified analysis did not report heterogeneity in several comparisons-pooling studies based on urine protein/creatinine ratio (UACR) showed that the adjusted OR with HCV was 1.64 (95% CI, 1.41; 1.91, P < 0.001) without heterogeneity (Q value by Chi-squared [χ2] test 9.98, P = NS). Meta-regression recorded a link between greater prevalence of proteinuria in males with HCV exposure (P = 0.03). Studies based on univariate analysis (n = 6, n = 72, 551 unique patients) gave similar results, pooled OR 1.54 (95% CI, 1.08; 2.19) (P = 0.0001).
Conclusions
An important relationship between HCV infection and higher risk of proteinuria in the general population exists. Research aimed to understand the biological mechanisms underlying such association is under way. We encourage to screen all patients with HCV exposure for proteinuria.
期刊介绍：
Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.
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