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Renal Manifestations of Chronic Hepatitis C: A Review
Aalam Sohal1, Carol Singh2, Akshita Bhalla3
1Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 2500, USA.
Insights
Hepatitis C virus (HCV) infection can cause significant kidney damage, particularly in those with chronic kidney disease. Early diagnosis and treatment of HCV are crucial for managing renal complications and improving outcomes in affected patients.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis C virus (HCV) is a global health issue causing liver damage.
- HCV infection is linked to extrahepatic manifestations, notably renal involvement, affecting 40% of patients.
- HCV-related renal disease significantly increases morbidity and mortality in chronic kidney disease (CKD) patients.
Purpose of the Study:
- To comprehensively review the renal manifestations of Hepatitis C virus (HCV) infection.
- To highlight the impact of HCV on kidney health, including specific glomerulonephritis types.
- To emphasize the importance of early HCV diagnosis and treatment for renal outcomes.
Main Methods:
- Literature review of studies on HCV and renal disease.
- Analysis of epidemiological data on HCV-related kidney complications.
- Synthesis of current treatment strategies, including directly acting antiviral agents (DAAs).
Main Results:
- HCV infection commonly leads to renal damage via cryoglobulinemia and glomerulonephritis (MPGN, MN).
- Untreated HCV contributes to significant renal complications, especially in patients undergoing hemodialysis or kidney transplantation.
- Kidney transplantation from HCV-infected donors is viable with effective post-transplant HCV treatment.
Conclusions:
- HCV poses a substantial threat to kidney health, necessitating proactive management.
- Early diagnosis and treatment of HCV are vital to prevent or mitigate severe renal complications.
- Optimizing HCV management in kidney disease patients, including pre-transplant strategies, improves overall prognosis.
Abstract:
Hepatitis C virus (HCV) has emerged as a major global health concern and, if left untreated, can lead to significant liver damage, including cirrhosis, decompensated liver disease, and hepatocellular carcinoma (HCC). Approximately 40% of patients with HCV infection experience extrahepatic manifestations, including renal involvement. HCV-related renal disease is of significant importance among patients with chronic kidney disease (CKD), leading to higher morbidity and mortality. The renal damage due to HCV infection primarily results from cryoglobulinemia and glomerulonephritis, with conditions such as membranoproliferative glomerulonephritis (MPGN) and membranous nephropathy (MN) being most prevalent. Despite advancements in treatment, including the use of directly acting antiviral agents (DAAs), renal complications remain a significant burden in untreated patients. HCV-positive patients on hemodialysis (HD) or those who have undergone kidney transplantation face increased mortality rates compared to their HCV-negative counterparts. Managing HCV infection before kidney transplantation is crucial to mitigate the risk of HCV-related renal complications. Conversely, kidney transplantation from HCV-infected donors is well established, as post-transplant treatment for HCV is safe and effective, potentially reducing mortality and morbidity for patients on transplant waiting lists. This review aims to provide a comprehensive analysis of the renal manifestations of HCV, emphasizing the importance of early diagnosis and treatment to improve patient outcomes.
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