Relationship between Hepatitis C and Chronic Kidney Disease in Southern Taiwan: Results from Community Complex Health Screening

Abstract

BACKGROUND: Chronic kidney disease (CKD) is an important and noteworthy health issue worldwide. It is especially a problem in Taiwan because of its high prevalence and incidence. Although previous studies suggested that hepatitis C virus (HCV) infections may lead to nephropathy, the effect of hepatitis C on renal function in Taiwanese adults is still not well understood.METHODS: From January 2002 to December 2006, we conducted a community-based medical screening program with 22,649 participants in Chiayi County, which is endemic for HCV infection. In this study, hepatitis B virus (HBV) and HCV infection were defined as a seropositive test result for hepatitis B surface antigen and HCV antibody. Advanced CKD was defined as estimated glomerular filtration rates (eGFR) lower than 60 mL/min per 1.73 m^2 , where eGFR was computed using the four-variable Modification of Diet in Renal Disease (MDRD) Study equation. Proteinuria was defined as the presence of urine protein of at least grade 1+. Age, gender, body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (T-chol), triglyceride (TG) were considered as potential confounders.RESULTS: The mean age of the study group was 59.3 years. Prevalence of HCV infection alone, HBV infection alone, HBV/HCV coinfection, and neither were 11.95%, 11.89%, 1.66%, and 74.49%, respectively. After a series of multivariate logistic regression analyses, we found that HCV infection was an independent risk factor for advanced CKD (OR, 1.111; P ＜ 0.05) and proteinuria (OR, 1.163; P ＜ 0.05). In addition, the prevalence of HCV seropositivity was higher in later CKD stages, changing from 15.8% in CKD stage IIIa to 22.7% in CKD stage I V.CONCLUSION: HCV infection was associated with an increased prevalence of advanced CKD and proteinuria in Taiwan, which is an area endemic for HCV and CKD.