Hepatitis C infection in patients with chronic kidney disease

A Mangia1, P Burra, A Ciancio

  • 1Division of Gastroenterology, General Hospital, IRCCS, San Giovanni Rotondo - Italy.

Insights

Managing hepatitis C virus (HCV) in patients with chronic kidney disease (CKD) is challenging. This systematic review addresses unresolved issues and provides expert consensus-based recommendations for HCV/CKD management.

Area of Science:

  • Nephrology
  • Hepatology
  • Infectious Diseases

Background:

  • Management of hepatitis C virus (HCV) in patients with chronic kidney disease (CKD) presents unique challenges.
  • Antiviral therapy, post-transplant care, and infection control in dialysis units remain significant concerns.
  • Existing clinical evidence is often limited to uncontrolled trials or retrospective data.

Purpose of the Study:

  • To systematically review the literature on HCV in the CKD population.
  • To address critical unresolved issues in HCV/CKD management.
  • To provide expert consensus-based recommendations.

Main Methods:

  • Systematic literature review.
  • Consensus development by experts.
  • Inclusion of clinical recommendations.

Main Results:

  • Identified key unresolved issues in HCV management for CKD patients.
  • Synthesized existing evidence through a systematic review.
  • Developed expert-driven consensus and recommendations.

Conclusions:

  • HCV management in CKD requires careful consideration of specific challenges.
  • Expert consensus provides guidance where robust clinical trials are lacking.
  • Recommendations aim to improve patient care and prevent HCV transmission.

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Hepatitis01:25

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...