Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection

[Guest guest]

http://www.springerlink.com/content/r530560567k86181/

Hepatology International

DOI: 10.1007/s12072-011-9284-9Online First™

Original Article

Higher prevalence of chronic kidney disease and shorter renal survival in

patients with chronic hepatitis C virus infection

Sanjaya Kumar Satapathy, Chandra Sekhar Lingisetty and

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.

Presented at the Young Investigators Forum of the Breckenridge Controversies in

Transplantation meeting held on March 6, 2010 at Beaver Run Resort, Colorado.

[Guest guest]

http://www.springerlink.com/content/r530560567k86181/

Hepatology International

DOI: 10.1007/s12072-011-9284-9Online First™

Original Article

Higher prevalence of chronic kidney disease and shorter renal survival in

patients with chronic hepatitis C virus infection

Sanjaya Kumar Satapathy, Chandra Sekhar Lingisetty and

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.

Presented at the Young Investigators Forum of the Breckenridge Controversies in

Transplantation meeting held on March 6, 2010 at Beaver Run Resort, Colorado.