Development rate of chronic kidney disease in hepatitis C virus patients with advanced fibrosis after interferon therapy

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nlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00845.x/abstract

Development rate of chronic kidney disease in hepatitis C virus patients with

advanced fibrosis after interferon therapy

Yasuji Arase, Fumitaka Suzuki, Yusuke Kawamura, Yoshiyuki Suzuki, Masahiro

Kobayashi, Naoki Matsumoto, Norio Akuta, Hitomi Sezaki, Tetsuya Hosaka, Kyoko

Ogawa, Norihiro Imai, Yuya Seko, Satoshi Saito, Kenji Ikeda, Mariko Kobayashi,

Hiromitsu Kumada

Article first published online: 24 AUG 2011

DOI: 10.1111/j.1872-034X.2011.00845.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Early View (Online Version of Record published before inclusion in an issue)

ABSTRACT

Aim:  The aim of this retrospective cohort study is to assess the development

incidence and predictive factors for chronic kidney disease (CKD) after the

termination of interferon therapy in hepatitis C virus (HCV) positive Japanese

patients with liver cirrhosis.

Methods:  A total of 650 HCV positive, liver cirrhotic patients who were

treated with interferon and showed an estimated glomerular filtration rate

(eGFR) of ≥60 mL/min per 1.73 m2 after the termination of interferon therapy

were enrolled. CKD was defined as an eGFR of <60 mL/min per 1.73 m2.

End-stage-CKD was defined as an eGFR of <15 mL/min/1.73 m2. The primary goal is

the new development of CKD and end-stage-CKD.

Results:  Eighty-five patients developed CKD, and six patients progressed to

end-stage-CKD. The development rate of CKD was 5.2% at the 5th year, 14.5% at

the 10th year and 30.6% at the 15th year. Multivariate proportional hazards

analysis showed that CKD occurred when patients had age increments of 10 years

(hazard ratio: 2.32; 95% confidence interval [CI] 1.61–3.35; P < 0.001), eGFR

decrements of 10 mL/min per 1.73 m2 (hazard ratio: 1.66; 95% CI 1.27–2.16; P <

0.001), hypertension (hazard ratio: 2.00; 95% CI 1.13–3.53; P = 0.017),

diabetes (hazard ratio: 1.79; 95% CI 1.02–3.14; P = 0.042), and non-clearance

of HCV (hazard ratio: 2.67; 95% CI 1.34–5.32; P = 0.005). The development rate

of end-stage-CKD was 0.4% at the 5th year, 1.6% at the 10th year and 2.8% at the

15th year.

Conclusions:  The annual incidence for CKD among cirrhotic patients with HCV

was determined to be about 1.0–1.5%. In addition, the annual incidence for

end-stage-CKD is one order of magnitude lower than that of CKD.