Abstract
The liver plays a key role in the metabolism of proteins. Liver dysfunction affects many organs because it communicates with the spleen and all digestive organs through the portal vein. Additionally, the kidney is an organ that is closely related to the liver and is involved in liver diseases. Glomerulonephritis is an important extrahepatic manifestation of chronic hepatitis B virus (HBV) infection. Nucleos(t)ide analog (NA) therapy effectively suppresses HBV replication by inhibiting HBV polymerase, thus decreasing the levels of serum HBV-DNA and delaying the progression of cirrhosis. Although NA therapy is recommended for all patients with chronic HBV infection, regardless of the level of renal dysfunction, there is limited information on NA use in patients with chronic kidney disease. In addition, in patients with end-stage liver cirrhosis, hepatorenal syndrome can be fatal. Hence, we should take into account the stage of impaired renal function in patients with cirrhosis. The aims of this article are to review the epidemiology, clinical presentation, treatment, and prevention of HBV-associated nephropathy.
Highlights
Despite the excellent efficacy of direct-acting antivirals (DAA) reported in hepatitis C virus (HCV), hepatitis B virus (HBV) still has problems that need to be addressed
In 1971, Combes reported on patients with hepatitis B with membranous kidney disease who presented with nephrotic syndrome
Renal diseases resulting from HBV infection are membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), polyarteritis nodosa (PAN), and mesangial proliferative glomerulonephritis (MesPGN)
Summary
Despite the excellent efficacy of direct-acting antivirals (DAA) reported in hepatitis C virus (HCV), hepatitis B virus (HBV) still has problems that need to be addressed. In 1971, Combes reported on patients with hepatitis B with membranous kidney disease who presented with nephrotic syndrome. They first reported the case of a middle-aged man with membranous glomerulonephritis due to glomerular deposition of Australian-antigen-containing immune complexes [1]. Oral nucleoside/nucleotide analogs (NAs) are currently the mainstream treatment for patients with chronic hepatitis B infection. Regarding the stage of liver cirrhosis, we should be aware of the possibility of impaired renal function at this stage of liver cirrhosis. Several biomarkers can be used to measure the early stage of impaired renal function in patients with cirrhosis. The aims of this article are to review the epidemiology, clinical presentation, treatment, and prevention of HBV-associated nephropathy
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