Clinical and pathological considerations on renal diseases in patients with chronic viral hepatitis

Chronic viral hepatitis B and C may associate different extrahepatic manifestations and renal disease is the most frequent. Kidney damage is represented in most cases by glomerulopathies, which include membranous nephropathy, membranoproliferative glomerulonephritis (MPGN), IgA nephropathy, focal and segmental glomerulosclerosis and diabetic nephropathy. We conducted a retrospective study on 639 patients diagnosed with chronic viral hepatitis B and C and different renal diseases. Complete evaluation of liver and renal status was performed and, in selected cases, renal biopsy. The evaluation of our cases allowed us to uncover that 82 (12.8%) patients presented a renal disease that could be linked to the viral infection. In order to identify the histopathological type of the renal lesions, kidney biopsy was performed in 39 of our patients. In hepatitis B virus (HBV) infection, the most frequent glomerulopathy was represented by membranous nephropathy, while in chronic hepatitis C infection, MPGN was responsible for the majority of glomerulonephritis. Most patients with MPGN and hepatitis C virus (HCV) also presented mixed cryoglobulinemia. Immunoglobulin A (IgA) nephropathy was present in both liver diseases while diabetic nephropathy was only found in HCV infection, in the context in which chronic hepatitis C is a risk factor for the development of type II diabetes mellitus.