Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection

Abstract

The role of hepatitis C virus infection (HCV) in the etiology and progression of chronic kidney disease (CKD) is controversial. To measure the prevalence of CKD and evaluate its course in patients with chronic HCV infection. A retrospective analysis was done after excluding patients with nephrolithiasis, structural kidney disease, and those with missing clinical information on 552 anti-HCV-positive patients and 313 patients without known HCV infection matched for age, race, and gender. CKD was defined as estimated glomerular filtration rate value of <60mL/min/1.73m(2) and/or persistence of proteinuria (>3months) on urine analysis by dipstick. Viral load obtained during the initial evaluation was defined as "baseline viral load". The prevalence of CKD in the anti-HCV-positive group was significantly higher compared to control group [53 (9.6%) vs. 16 (5.1%), P=0.02]. On multivariate regression analysis, higher age, hypertension, HCV PCR>7×10(5)cps/mL, and diabetes mellitus were significant independent positive predictors, whereas history of interferon treatment was significant independent negative predictor for CKD. Male gender, human immunodeficiency virus status, body weight, intravenous drug use, and HCV genotype were not predictors of CKD. Analysis of renal survival through Kaplan-Meyer curves revealed significantly shorter time to develop CKD (74 vs. 84months, P<0.001; log rank) and end-stage renal disease (79.9 vs. 86.5months, P=0.005; log rank) in the HCV group compared to the control group. Chronic HCV infection was associated with a significantly higher prevalence of CKD compared with controls, as well as significantly shorter renal survival. A higher baseline viral load is an independent predictor of CKD.