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[Chronic viral hepatitis and kidney failure].
Nabil Ben Chaabane1, Hichem Loghmari, Wissem Melki
1Service de gastroentérologie, CHU de Monastir, TN-5000 Monastir, Tunisie. nabilca@yahoo.fr
Presse Medicale (Paris, France : 1983)
|February 23, 2008
Summary
Chronic viral hepatitis is a significant issue for kidney disease patients, often showing normal liver enzymes despite liver damage. Prevention through vaccination and hygiene is key, with antiviral treatments reserved for specific cases.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Chronic viral hepatitis (Hepatitis B and C) poses a significant threat to patients with chronic renal failure, impacting patient and graft survival post-transplant.
- Infection often presents with normal transaminase levels despite viremia and progressive liver damage, complicating diagnosis and management.
- Cirrhosis is a critical factor, contraindicating single kidney transplantation due to increased risks.
Purpose of the Study:
- To review the challenges and management strategies for chronic viral hepatitis in patients with chronic renal failure.
- To highlight the diagnostic importance of liver biopsy in this population.
- To discuss preventive measures and current antiviral treatment considerations.
Main Methods:
- Literature review focusing on viral hepatitis in renal failure patients.
- Analysis of diagnostic approaches, including liver biopsy.
- Evaluation of preventive strategies like vaccination and hygiene.
- Assessment of antiviral therapies (interferon, lamivudine) in hemodialysis patients.
Main Results:
- Hepatitis B and C are common in dialysis and transplant patients, reducing survival.
- Liver biopsy is crucial for staging liver disease.
- Preventive measures are the most effective treatment.
- Alpha interferon is ineffective and poorly tolerated in dialysis patients.
- Lamivudine shows promise but requires further study on long-term efficacy and optimal dosing.
Conclusions:
- Chronic viral hepatitis significantly impacts renal failure patients; prevention is paramount.
- Liver biopsy is essential for managing transplant candidates.
- While lamivudine is a potential treatment for dialysis patients, its long-term use and dosage need further investigation.
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