Epidemiology

Hepatitis C virus infection not directly tied to kidney disease

Last Updated: 2008-07-08 14:01:28 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Infection with hepatitis C virus per se is not associated with an increased risk of developing chronic kidney disease, according to findings published in the June issue of the American Journal of Kidney Diseases.

"Hepatitis C and chronic kidney disease (CKD) are both highly prevalent diseases in the United States," Dr. Sharon M. Moe and colleagues from Indiana University School of Medicine, Indianapolis, write. "We hypothesized that infection with hepatitis C virus increased the risk of CKD and accelerated progression to CKD."

To test this, they conducted retrospective cross-sectional and longitudinal analyses of data on 13,139 African American and white patients tested for hepatitis C between 1994 and 2004.

The team identified 3938 patients (30.0%) with hepatitis C and 2549 (19.4%) who had CKD. In cross-sectional analysis, after controlling for diabetes, hypertension, age, liver enzymes, and HIV status, hepatitis C was significantly associated with decreased risk of CKD (odds ratio 0.694).

A total of 7038 subjects without CKD were followed for a median of 3.5 years. Of these, 2243 (31.8%) had hepatitis C at the onset of follow-up. Results of longitudinal analysis, after adjusting for multiple confounders, showed that being hepatitis C positive was associated with a nonsignificant decreased risk of developing CKD (hazard ratio 0.896).

"These data do not support widespread testing for hepatitis C as a means to identify patients at risk of CKD," Dr. Moe's team concludes.

"However, our data do not preclude testing patients with known CKD for hepatitis C because some data showed that hepatitis C may worsen the rate of progression of CKD, especially in patients with diabetic nephropathy," they note. "In addition, seropositivity is high in dialysis units and may lead to more problems with transplantation."

Am J Kidney Dis 2008;51:885-892.