Viral hepatitis as a cause of renal disease

Viral hepatitis has become a recognized cause of both acute and chronic renal disease. Acute and chronic viral infections may result in formation of immune complexes that can become deposited in the glomerular capillary basement membrane, stimulating both cytokine production and complement activation and producing a variety of glomerular lesions. Chronic viral infections may also result in production of mixed polyclonal IgG and monoclonal IgM cryoglobulins, which result in systemic vasculitic syndromes that also involve the kidney. Glomerular injury through these mechanisms may become clinically manifested as either acute glomerulonephritis or the nephrotic syndrome. Because of the worldwide prevalence of hepatitis B and C infections, they are important public health problems that may lead to a variety of important renal diseases. Further understanding of the mechanisms by which these viruses induce injury will allow more effective treatment strategies to reverse the renal diseases induced by hepatotropic viral infection.