Renal involvement in patients with hepatitis C virus infection
Fereshteh Saddadi1, Fatemeh Attari, Iraj Najafi
1Division of Nephrology, Department of Medicine and Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. saddadi_md@yahoo.com
Insights
Hepatitis C virus (HCV) infection can affect the kidneys, leading to conditions like membranoproliferative glomerulonephritis (MPGN). This study found renal involvement in HCV patients, with MPGN being a common immune complex kidney disease in this population.
Area of Science:
- Nephrology
- Hepatology
- Immunology
Background:
- Hepatitis C virus (HCV) is a hepatotropic virus associated with extrahepatic manifestations.
- HCV infection is a risk factor for diseases like mixed cryoglobulinemia and membranoproliferative glomerulonephritis (MPGN).
Purpose of the Study:
- To evaluate the prevalence and characteristics of renal involvement in Hepatitis C virus (HCV)-infected patients.
Main Methods:
- 300 HCV antibody-positive outpatients were enrolled.
- Serum creatinine and glomerular filtration rate (GFR) were measured.
- 24-hour urine samples were analyzed for proteinuria.
Main Results:
- Proteinuria was detected in 4% of patients; one case of MPGN was confirmed via biopsy.
- Low GFR was observed in 0.7% of patients.
- No significant association was found between HCV seropositivity and low GFR.
Conclusions:
- Renal involvement is present in HCV antibody-positive patients.
- MPGN without cryoglobulins is a common immune complex glomerular disease in HCV patients.
Introduction:
Hepatitis C virus (HCV) infection is a hepatotropic virus causing a variety of extrahepatic immunological manifestations and is a risk factor of a variety of extrahepatic diseases, such as mixed cryoglobulinemia and membranoproliferative glomerulonephritis (MPGN), which is the most common glomerulonephritis. The aim of this study was to evaluate renal involvement in HCV-infected patients.
Materials And Methods:
A total of 300 randomly-selected HCV antibody-positive outpatients at the HCV clinic of Shariati hospital were enrolled. Serum creatinine was measured and glomerular filtration rate was estimated accordingly. Urine proteinuria was measured in 24-hour urine samples.
Results:
The patients were 249 men (83.2%) and 51 women (16.8%) with a mean age of 37.8 +/- 11.7 years (range, 18 to 70 years). Proteinuria was found in 12 HCV antibody-positive adults (4%), 1 of whom underwent biopsy. He was a 55- year-old man with a 4-month history of facial and lower extremities edema and 3-g proteinuria with a normal kidney function (glomerular filtration rate, 85 mL/min) and normocomplementemia. Kidney biopsy specimens showed MPGN. The frequency of low glomerular filtration rate was 0.7% (2 patients) in the HCV antibody-positive adults. There was no significant relationship between HCV seropositivity and low glomerular filtration rate.
Conclusions:
Our observations showed renal involvement in HCV antibody-positive patients. Among immune complex glomerular kidney diseases, MPGN without cryoglobulins is thought to be the most common in these patients.
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