Hepatitis C and kidney disease: A narrative review

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• 作者：Rashad S. Barsoum^a ; ^b ; ^{Rashad.barsoum@gmail.com}Author Vitae ; Emad A. William^b ; ^cAuthor Vitae ; Soha S. Khalil^bAuthor Vitae
• 关键词：Acute kidney injury ; Chronic kidney disease ; Glomerulonephritis ; Dialysis ; Renal transplantation ; Direct-acting antivirals
• 刊名：Journal of Advanced Research
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：8
• 期：2
• 页码：113-130
• 全文大小：4553 K
• 卷排序：8

文摘

Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis. HCV-infected patients are at increased risk of acute post-transplant complications. Long-term graft survival is compromised by recurrent or de novo glomerulonephritis, or chronic transplant glomerulopathy. Patient survival is challenged by increased incidence of diabetes, sepsis, post-transplant lymphoproliferative disease, and liver failure. Effective and safe directly acting antiviral agents (DAAs) are currently available for treatment at different stages of kidney disease. However, the relative shortage of DAAs in countries where HCV is highly endemic imposes a need for treatment-prioritization, for which a scoring system is proposed in this review. It is concluded that the thoughtful use of DAAs, will result in a significant change in the epidemiology and clinical profiles of kidney disease, as well as improvement of dialysis and transplant outcomes, in endemic areas.