Abstract
Background
The role of hepatitis C virus infection (HCV) in the etiology and progression of chronic kidney disease (CKD) is controversial.
Aim
To measure the prevalence of CKD and evaluate its course in patients with chronic HCV infection.
Methods
A retrospective analysis was done after excluding patients with nephrolithiasis, structural kidney disease, and those with missing clinical information on 552 anti-HCV-positive patients and 313 patients without known HCV infection matched for age, race, and gender. CKD was defined as estimated glomerular filtration rate value of <60 mL/min/1.73 m2 and/or persistence of proteinuria (>3 months) on urine analysis by dipstick. Viral load obtained during the initial evaluation was defined as “baseline viral load”.
Results
The prevalence of CKD in the anti-HCV-positive group was significantly higher compared to control group [53 (9.6%) vs. 16 (5.1%), P = 0.02]. On multivariate regression analysis, higher age, hypertension, HCV PCR > 7 × 105 cps/mL, and diabetes mellitus were significant independent positive predictors, whereas history of interferon treatment was significant independent negative predictor for CKD. Male gender, human immunodeficiency virus status, body weight, intravenous drug use, and HCV genotype were not predictors of CKD. Analysis of renal survival through Kaplan–Meyer curves revealed significantly shorter time to develop CKD (74 vs. 84 months, P < 0.001; log rank) and end-stage renal disease (79.9 vs. 86.5 months, P = 0.005; log rank) in the HCV group compared to the control group.
Conclusion
Chronic HCV infection was associated with a significantly higher prevalence of CKD compared with controls, as well as significantly shorter renal survival. A higher baseline viral load is an independent predictor of CKD.
Similar content being viewed by others
References
Sabry AA, Sobh MA, Irving WL, et al. A comprehensive study of the association between hepatitis C virus and glomerulopathy. Nephrol Dial Transplant 2002;17:239–245
Kamar N, Izopet J, Alric L, Guilbeaud-Frugier C, Rostaing L. Hepatitis C virus-related kidney disease: an overview. Clin Nephrol 2008;69:149–160
Cao Y, Zhang Y, Wang S, Zou W. Detection of the hepatitis C virus antigen in kidney tissue from infected patients with various glomerulonephritis. Nephrol Dial Transplant 2009;24:2745–2751
Tsui JI, Vittinghoff E, Shlipak MG, O’Hare AM. Relationship between hepatitis C and chronic kidney disease: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol 2006;17:1168–1174
Liangpunsakul S, Chalasani N. Relationship between hepatitis C and microalbuminuria: results from the NHANES III. Kidney Int 2005;67:285–290
Tsui JI, Vittinghoff E, Shlipak MG, et al. Association of hepatitis C seropositivity with increased risk for developing end-stage renal disease. Arch Intern Med 2007;167:1271–1276
Fabrizi F, Marcelli D, Bacchini G, Guarnori I, Erba G, Locatelli F. Antibodies to hepatitis C virus (HCV) in chronic renal failure (CRF) patients on conservative therapy: prevalence, risk factors and relationship to liver disease. Nephrol Dial Transplant 1994;9:780–784
Soma J, Saito T, Taguma Y, et al. High prevalence and adverse effect of hepatitis C virus infection in type II diabetic-related nephropathy. J Am Soc Nephrol 2000;11:690–699
Crook ED, Penumalee S, Gavini B, Filippova K. Hepatitis C is a predictor of poorer renal survival in diabetic patients. Diabetes Care 2005;28:2187–2191
Kasuno K, Ono T, Matsumori A, et al. Hepatitis C virus-associated tubulointerstitial injury. Am J Kidney Dis 2003;41:767–775
Sansonno D, Lauletta G, Montrone M, Grandaliano G, Schena FP, Dammacco F. Hepatitis C virus RNA and core protein in kidney glomerular and tubular structures isolated with laser capture microdissection. Clin Exp Immunol 2005;140:498–506
Moe SM, Pampalone AJ, Ofner S, Rosenman M, Teal E, Hui SL. Association of hepatitis C virus infection with prevalence and development of kidney disease. Am J Kidney Dis 2008;51:885–892
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39:S1–S266
Mehta SH, Brancati FL, Strathdee SA, et al. Hepatitis C virus infection and incident type 2 diabetes. Hepatology 2003;38:50–56
Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo M, Thomas DL. Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med 2000;133:592–599
Fabrizi F, Pozzi C, Farina M, et al. Hepatitis C virus infection and acute or chronic glomerulonephritis: an epidemiological and clinical appraisal. Nephrol Dial Transplant 1998;13:1991–1997
Johnson RJ, Gretch DR, Yamabe H, et al. Membranoproliferative glomerulonephritis associated with hepatitis C virus infection. N Engl J Med 1993;328:465–470
Daghestani L, Pomeroy C. Renal manifestations of hepatitis C infection. Am J Med 1999;106:347–354
Fukui M, Kitagawa Y, Nakamura N, Yoshikawa T. Hepatitis C virus and atherosclerosis in patients with type 2 diabetes. JAMA 2003;289:1245–1246
Ishizaka N, Ishizaka Y, Takahashi E, et al. Association between hepatitis C virus seropositivity, carotid-artery plaque, and intima-media thickening. Lancet 2002;359:133–135
Vassalle C, Masini S, Bianchi F, Zucchelli GC. Evidence for association between hepatitis C virus seropositivity and coronary artery disease. Heart 2004;90:565–566
Taskapan H, Oymak O, Dogukan A, Utas C. Patient to patient transmission of hepatitis C virus in hemodialysis units. Clin Nephrol 2001;55:477–481
Bergman S, Accortt N, Turner A, Glaze J. Hepatitis C infection is acquired pre-ESRD. Am J Kidney Dis 2005;45:684–689
Sterling RK, Sanyal AJ, Luketic VA, et al. Chronic hepatitis C infection in patients with end stage renal disease: characterization of liver histology and viral load in patients awaiting renal transplantation. Am J Gastroenterol 1999;94:3576–3582
Hatoum HH, Rzouq F. The Direct Impact of Hepatitis C Viral Load on Kidney Function. ACG 2009; Abstract P192
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Satapathy, S.K., Lingisetty, C.S. & Williams, S. Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection. Hepatol Int 6, 369–378 (2012). https://doi.org/10.1007/s12072-011-9284-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12072-011-9284-9