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Hepatitis C virus infection increases risk of developing end-stage renal disease using competing risk analysis

Jia-Jung Lee1, Ming-Yen Lin2, Jung-San Chang3

  • 1Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Plos One
|June 28, 2014
PubMed

Insights

Hepatitis C virus (HCV) infection increases the risk of developing end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD). This finding was determined using a competing risk model, accounting for mortality.

Area of Science:

  • Nephrology
  • Hepatology
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) and hepatitis C virus (HCV) infection are significant contributors to patient mortality.
  • The link between HCV and the risk of end-stage renal disease (ESRD) requires further investigation using advanced statistical models.

Purpose of the Study:

  • To analyze the association between HCV infection and the risk of developing ESRD within a CKD cohort.
  • To compare the risk of ESRD associated with HCV infection versus hepatitis B virus (HBV) infection in CKD patients.

Main Methods:

  • A prospective cohort of 4,185 CKD patients was followed for 9,101 person-years.
  • A competing risk model was employed to analyze the association of HCV and HBV infections with ESRD incidence, adjusting for mortality.
  • HCV infection was defined by anti-HCV antibody seropositivity, and HBV infection by HBV surface antigen seropositivity.

Main Results:

  • HCV infection prevalence was 7.6% and increased with CKD stage (P<0.001).
  • After adjusting for competing risk of death, HCV infection was associated with a significantly higher 5-year cumulative incidence of ESRD (52.6% vs. 38.4%, P<0.001).
  • Multivariable analysis revealed that HCV infection, but not HBV infection, significantly increased the risk of developing ESRD (HCV HR: 1.32, 95% CI: 1.07-1.62).

Conclusions:

  • HCV infection is independently associated with an increased risk of developing ESRD in patients with CKD.
  • The findings underscore the importance of considering HCV status in managing CKD patients to mitigate ESRD risk.
Abstract

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