Kidney disease in patients with chronic hepatitis c
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
There is an increasing recognition of the association between chronic hepatitis C virus infection and glomerular diseases. Renal complications may be the presenting manifestation of hepatitis C virus infection. Patients may present with signs and symptoms of cryoglobulinemic systemic vasculitis, proteinuria, microscopic hematuria, acute renal failure, or nephrotic syndrome. The pathogenesis of hepatitis C virus associated with renal disease remains incompletely understood; however, deposition of circulating immune complexes in the subendothelial space and mesangium in the glomeruli seems to play a major role. The most common renal pathology associated with hepatitis C virus infection is type I membranoproliferative glomerulonephritis with or without cryoglobulinemia. In patents who do not have significant renal impairment, combination therapy with interferon alfa (IFN-α) and ribavirin seems to be the treatment of choice, although the experience with this combination is quite limited in patients with renal involvement. A prolonged course of high-dose IFN-α has been most commonly used for these patients with significant success, but relapse of hepatitis C viremia and renal disease after discontinuation of therapy have frequently occurred.
- Amico G, Colasanti G, Ferrario F, Sinico RA: Renal involvement in essential mixed cryoglobulinemia. Kidney Int 1989, 35:1004–1014.
- Harle J, Disder P, Dussol B, et al.: Membranoproliferative glomerulonephritis and hepatitis C infection. Lancet 1993, 341:904. CrossRef
- Doutrelepont JM, Adler M, Willens M, Yap SH: Hepatitis C infection and membranoproliferative glomerulonephritis. Lancet 1993, 341:317. CrossRef
- Yamabe H, Johnson RJ, Gretch DR, et al.: Hepatitis C virus infection and membranoproliferative glomerulonephritis in Japan. J Am Soc Nephrol 1995, 6:220–223.
- Johnson RJ, Gretch DR, Yamabe H, et al.: Membranoproliferative glomerulonephritis associated with hepatitis C virus infection. N Engl J Med 1993, 328:465–470. CrossRef
- Davda R, Peterson J, Weiner R, et al.: Membranous glomerulonephritis in association with hepatitis C virus infection. Am J Kidney Dis 1993, 22:452–455.
- Stehman-Breen C, Willson R, Alpers C, et al.: Hepatitis C virus associated membranous glomerulonephritis. Curr Opin Nephrol Hypertens 1995, 4:287–294. CrossRef
- Pol S, Thiers V, Carnot F, et al.: Efficacy and tolerance of alpha-2b interferon therapy on HCV infection of hemodialyzed patients. Kidney Int 1995, 47:1412–1418.
- Selby P, Kohn J, Raymond J, et al.: Nephrotic syndrome during treatment with interferon. Br Med J 1985, 290:1180.
- Usalan C, Erdem Y, Altun B, et al.: Rapidly progressive glomerulonephritis associated with hepatitis C virus infection. Clin Nephrol 1998, 49:129–131. A case report of a 20-year-old woman who developed rapidly progressive glomerulonephritis during the course of active HCV infection. Whether this is a true association or a coincidental finding is unknown.
- Coroneos E, Truong L, Olivero J: Fibrillary glomerulonephritis associated with hepatitis C viral infection. Am J Kidney Dis 1997, 29:132–135.
- Markowitz GS, Cheng JT, Colvin RB, et al.: Hepatitis C viral infection is associated with fibrillary glomerulonephritis and immunotactoid glomerulopathy. J Am Soc Nephrol 1998, 9:2244–2252. Report of four cases of fibrillary glomerulonephritis and two cases of immunotactoid glomerulopathy in association with HCV infection. Outcomes were variable.
- Ferri C, Greco F, Longombardo G, et al.: Antibodies against hepatitis C virus in mixed cryoglobulinemia patients. Infection 1991, 19:417–420. CrossRef
- Ferri C, Greco F, Longombardo G, et al.: Hepatitis C virus antibodies in mixed cryoglobulinemia. Clin Exper Rheumatol 1991, 9:95–96.
- Stokes MB, Chawla H, Brody RI, et al.: Immune complex glomerulonephritis in patients coinfected with human immunodeficiency virus and hepatitis C virus. Am J Kidney Dis 1997, 29:514–525.
- Morales E, Alegre R, Herrero JC, et al.: Hepatitis-C-virusassociated cryoglobulinaemic membranoproliferative glomerulonephritis in patients infected by HIV. Nephrol Dial Transplant 1997, 12:1980–1984. CrossRef
- Rivera M, Gonzalo A, Maqmpaso, et al.: The heterogeneity of glomerulonephritis associated with HIV. Nephrol Dial Transplant 1999, 14:244–245. Report of four patients with HCV/HIV co-infection who were noted to have the following renal histopathologies: membranous nephropathy in two patients, focal segmental glomerulosclerosis in one, and diffuse proliferative glomerulonephritis in the other. CrossRef
- Beaufils H, Jouanneau C, Katlama C, et al.: HIV-associated IgA nephropathy: a postmortem study. Nephrol Dial Transplant 1995, 10:35–38.
- Horikoshi S, Okada T, Shirato I, et al.: Diffuse proliferative glomerulonephritis with hepatitis C virus-like particles in paramesangial dense deposits in a patient with chronic hepatitis C virus hepatitis. Nephron 1993, 64:482–484. CrossRef
- Pucillo L, Agnello V: Membranoproliferative glomerulonephritis associated with hepatitis B and C viral infections: from virus-like particles in the cryoprecipitate to viral localization in paramesangial deposits, problematic investigations prone to artifacts. Curr Opin Nephrol Hypertens 1994, 3:465–470. CrossRef
- Fornasieri A, Armelloni S, Bernasconi P, et al.: High binding of immunoglobulin M kappa rheumatoid factor from type II cryoglobulins to cellular fibronectin: a mechanism for induction of in situ immune complex glomerulonephritis? Am J Kidney Dis 1996, 27:476–483.
- Sansonno D, Gesualdo L, Manno C, et al.: Hepatitis C virus-related proteins in kidney tissue from hepatitis C virus-infected patients with cryoglobulinemic membranoproliferative glomerulonephritis. Hepatology 1997, 25:1237–1244. CrossRef
- Misiani R, Bellavita P, Fenili D, et al.: Interferon alfa-2a therapy in cryoglobulinemia associated with hepatitis C virus. N Engl J Med 1994, 330:751–756. CrossRef
- Sarac E, Bastacky S, Johnson JP: Response to high-dose alfa interferon after failure of standard therapy in MPGN associated with HCV infection. Am J Kidney Dis 1997, 30:113–115.
- Johnson RJ, Gretch DR, Couser WG, et al.: Hepatitis C virusassociated glomerulonephritis.: effect of alpha-interferon therapy. Kidney Int 1994, 46:1700–1704.
- Morosetti M, Sciarra G, Meloni C, et al.: Membranoproliferative glomerulonephritis and hepatitis C: effects of interferon-alpha therapy on clinical outcome and histological pattern. Nephrol Dial Transplant 1996, 11:532–534.
- Polynard T, Leroy V, Cohard M, et al.: Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: effects of dose and duration. Hepatology 1996, 24:778–789. CrossRef
- Baid S, Pascual M, Williams W, et al.: Renal thrombotic microangiopathy associated with anticardiolipin antibodies in hepatitis C-positive renal allograft receipients. J Am Soc Nephrol 1999, 10:146–153. According to this report, all five patients (out of 18 recipients of HCVpositive serology pretransplant) with biopsy-proven de novo renal thrombotic microangiopathy (RTMA) had a positive ACA test, compared with only one of 13 patients without RTMA. The occurrence of this condition may reflect unfavorable outcome for patient and graft survival.
- Legendre CH, Garrigue V, Le Bihan C, et al.: Harmful long-term impact of hepatitis C virus infection in kidney transplant receipients. Transplantation 1998, 65:667–670. Report on a retrospective study from France comparing patient survival and cause of death among anti-HCV-positive (n=387) and - negative (n=112) transplant recipients. Anti-HCV-positive patients had significantly shorter patient and graft long-term survival than anti-HCV-negative patients. Increased mortality was primarily due to liver disease and sepsis. CrossRef
- Kidney disease in patients with chronic hepatitis c
Current Gastroenterology Reports
Volume 3, Issue 1 , pp 79-83
- Cover Date
- Print ISSN
- Online ISSN
- Current Medicine Group
- Additional Links
- Industry Sectors