Reuters Health Information (2005-09-21): Chronic hepatitis C presents differently in end-stage renal disease patients
Chronic hepatitis C presents differently in end-stage renal disease patients
Last Updated: 2005-09-21 14:11:21 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The presentation and
natural history of chronic hepatitis C differs between patients with
and without end-stage renal disease (ESRD), according to a report in
the September American Journal of Gastroenterology.
Though the natural history of chronic hepatitis C in patients with
normal renal function has been studied extensively, the authors
explain, this is the first report of its natural history in patients
Dr. Ke-Qin Hu from University of California, Irvine Medical Center,
Orange, and colleagues investigated the clinical presentation of
chronic hepatitis C and factors associated with stage III-IV fibrosis
in 91 patients with chronic hepatitis C and ESRD on hemodialysis,
compared with 159 otherwise similar patients without renal failure.
Patients with ESRD had a lower mean body-mass index and a lower
frequency of fibrosis than did patients without renal failure, the
authors report. Patients with ESRD were more likely to have diabetes
than were patients without renal failure.
ESRD patients were less likely than the others to present with
elevated liver enzymes (ALT and AST), the results indicate, and more
likely to present with hypoalbuminemia.
"The frequency of elevated alpha-fetoprotein (AFP) is significantly
lower in patients with chronic hepatitis C and ESRD than in those with
chronic hepatitis C and normal renal function," the investigators
Hepatic steatosis and thrombocytopenia were independently associated
with stage III-IV fibrosis in ESRD patients, the researchers note, even
after accounting for a history of diabetes, elevated AST level, and
"Except for a history of diabetes mellitus and a lower frequency of
elevated AST, the overall presentation of stage III-IV fibrosis is
similar in chronic hepatitis C patients with ESRD or normal renal
function," the authors conclude.
"Additional study with a larger cohort of patients will be needed to
determine whether a low level of AFP is associated with less activity
and progression of hepatitis C virus disease in patients with ESRD,"
the researchers add.
Am J Gastroenterol 2005;100:2010-2018.