Direct-acting antivirals improve kidney function in diabetic patients with HCV infection and chronic kidney disease

Area of Science:

• Nephrology
• Hepatology
• Endocrinology

Background:

• Direct-acting antivirals (DAAs) have increased treatment for chronic Hepatitis C virus (HCV) infection in diabetic patients.
• HCV clearance impacts cardiovascular risk and insulin resistance, potentially affecting diabetic microvascular complications like nephropathy.

Purpose of the Study:

• To assess kidney function changes after DAA treatment completion in diabetic and non-diabetic patients with chronic HCV infection.
• To identify patient subgroups benefiting most from antiviral therapy regarding renal function.

Main Methods:

• Evaluated serum creatinine and estimated glomerular filtration rate (eGFR) at baseline, treatment completion, and 12 weeks post-treatment.
• Conducted subgroup analyses based on age, DAA regimen, and baseline eGFR stage.
• Compared kidney function changes between diabetic (N=96) and non-diabetic (N=187) patient groups.

Main Results:

• Diabetic patients showed a significant improvement in eGFR (from 83.7 to 102.6 ml/min/1.73 m² at 12 weeks post-treatment; p=0.028).
• Kidney function improvement was particularly noted in older diabetic patients (≥65 years) and those with baseline eGFR < 60 ml/min/1.73 m².
• No significant changes in serum creatinine were observed; DAA regimens did not influence eGFR outcomes. Sixteen percent of diabetic patients experienced a one-category improvement in eGFR.

Conclusions:

• DAA therapy improves renal function in diabetic patients with chronic HCV, especially in elderly individuals and those with pre-existing kidney impairment (eGFR < 60 ml/min/1.73 m²).
• HCV treatment offers a potential strategy for managing diabetic nephropathy, independent of the specific DAA regimen used.
• No acute kidney injury events were reported, suggesting a favorable safety profile for renal function during HCV treatment.