Association Between Hepatitis B Virus and Chronic Kidney Disease: a Systematic Review and Meta-analysis
Association Between Hepatitis B Virus and Chronic Kidney Disease: a Systematic Review and Meta-analysis
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DOI：
10.5604/16652681.1226813
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发表时间：
2017-02-01
影响因子：
3.8
通讯作者：
Messa, Piergiorgio
中科院分区：
文献类型：
--
作者：
Fabrizi, Fabrizio;Donato, Francesca M.;Messa, Piergiorgio
背景B型肝炎病毒感染和慢性肾脏疾病是普遍存在的，并且仍然是世界范围内的主要公共卫生问题。目前尚不清楚如何感染B型肝炎病毒的发展和进展的影响慢性肾脏病的发病率和progression of chronic kidney disease.AIM：To evaluate the effect of infection with HBV on the risk of chronic kidney disease in the general population.MATERIAL AND METHODS：我们进行了一项系统的回顾性研究，已发表的医学文献，以确定是否B型肝炎感染与慢性肾脏病的可能性增加。我们使用DerSimonian和Laird的随机效应模型，在已发表的研究中对B型肝炎病毒引起的慢性肾脏疾病（定义为肾小球滤过率降低和/或可检测到的蛋白尿）的相对风险进行了汇总估计。结果：共纳入16项研究（n = 394，664例患者），根据研究结果进行Meta分析。针对ESRD的纵向研究子集（n = 2; n = 91，656）在HBV感染患者中得出汇总aHR 3.87（95%CI，1.48; 6.25，P < 0.0001），未记录异质性。在荟萃回归分析中，我们注意到男性（P = 0.006）和随访持续时间（P = 0.007）对慢性肾脏疾病（包括终末期肾脏疾病）发生率的校正风险比的影响。HBV阳性与慢性病患病率无相关性（n = 7，n = 109，889例独特患者）;调整后的比值比为1.07（95% CI，0.89; 1.25）和0.93结论：在一般人群中，HBV感染可能与肾小球滤过率降低的风险相关;在横断面调查中没有发现HBV血清阳性状态与慢性肾脏疾病或蛋白尿的发生率之间存在联系。
Background. Hepatitis B virus infection and chronic kidney disease are prevalent and remain a major public health problem worldwide. It remains unclear how infection with hepatitis B virus impacts on the development and progression of chronic kidney disease.AIM: To evaluate the effect of infection with HBV on the risk of chronic kidney disease in the general population.MATERIAL AND METHODS: We conducted a systematic review of the published medical literature to determine if hepatitis B infection is associated with increased likelihood of chronic kidney disease. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) with hepatitis B virus across the published studies. Meta-regression and stratified analysis were also conducted.RESULTS:We identified 16 studies (n = 394,664 patients) and separate meta-analyses were performed according to the outcome. The subset of longitudinal studies addressing ESRD (n = 2; n = 91,656) gave a pooled aHR 3.87 (95% CI, 1.48; 6.25, P < 0.0001) among HBV-infected patients and no heterogeneity was recorded. In meta-regression, we noted the impact of male (P = 0.006) and duration of follow- up (P = 0.007) upon the adjusted hazard ratio of incidence of chronic kidney disease (including end-stage renal disease). No relationship occurred between HBV positive status and prevalent chronic disease (n = 7, n = 109,889 unique patients); adjusted odds ratio, were 1.07 (95% CI, 0.89; 1.25) and 0.93 (95% CI, 0.76; 1.10), respectively.CONCLUSIONS:HBV infection is possibly associated with a risk of developing reduced glomerular filtration rate in the general population; no link between HBV sero-positive status and frequency of chronic kidney disease or proteinuria was noted in cross-sectional surveys.