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It is well known that patients with chronic hepatitis C virus (HCV) infection have an increased risk of chronic kidney disease (CKD), regardless of whether they have additional risk factors for renal insufficiency. In a recent meta-analysis of nearly 3 million individuals where kidney function and HCV serological status were assessed, chronic HCV infection predicted a 51% increase in the risk of proteinuria and a 43% increase in the incidence of CKD.
Background of Hepatitis C and Chronic Kidney Disease
Patients with CKD have a higher prevalence of HCV infection compared with the general population. Chronic HCV infection is associated with a 23% higher risk of presenting with CKD when compared to uninfected patients. Two large cohort analysis including more than 150 000 United States (US) veterans with chronic HCV infection suggests that this population has an almost twofold increased risk of end-stage renal disease (ESRD). In addition, the presence of HCV was associated with rapid deterioration of renal function. The duration of chronic HCV infection also appears to influence the risk of developing CKD. In another US veterans study, recent HCV seroconversion (≤12 months) was not a major risk factor for CKD, but cirrhosis and other comorbidities contributed to the significantly increased prevalence of CKD among patients with chronic HCV infection. Several potential explanations for the higher risk of adverse renal events in HCV-infected patients have been provided. The presence of cryoglobulins or HCV-antibody immune complexes deposition could be responsible for kidney injury due to systemic immune response to chronic HCV infection. or there may be a cytopathic effect of HCV on renal tissue.
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