Chronic Hepatitis C Increases the Risk of Chronic Kidney Disease (CKD) while Effective HCV Treatment Decreases the Incidence of CKD

ABSTRACT

We aimed to assess the risk of chronic kidney disease (CKD) in chronic hepatitis C virus (HCV) infected patients and the incidence reduction of CKD after receipt of HCV treatment. We also evaluated the risk of membranoproliferative glomerulonephritis (MPGN) and cryoglobulinemia in chronic HCV patients. A retrospective cohort analysis of the Truven Health MarketScan Database (2008-2015) in the United States was conducted. In a cohort of 56,448 HCV-infected patients and propensity score (1:3) matched 169,344 non-HCV patients, we examined the association of HCV infection with the incidence of CKD. Of 55,818 HCV patients, 6.6% (n=3666), 6.3% (n=3534), and 8.3% (n=4628) patients received either interferon-based dual, triple, or all-oral direct acting antiviral agents (DAA) therapy, respectively, whereas 79% of patients did not receive any HCV treatment. Cox proportional hazards models were used to compare the risk of developing CKD in HCV patients compared to non-HCV patients and treated patients compared to non-treated HCV patients. In a multivariate time-varying Cox regression model, HCV-infected patients had a 27% increased risk of CKD compared to non-HCV patients (hazard ratio (HR),1.27; 95% confidence interval (CI),1.18-1.37). Among HCV patients, individuals who received the minimally effective HCV treatment for dual, triple, or all-oral therapy had a 30% decreased risk of developing CKD (HR,0.70; 95% CI,0.55-0.88). In addition, HCV-infected patients experienced a twofold and a nearly 17-fold higher risk of MPGN (HR,2.23; 95% CI,1.84-2.71) and cryoglobulinemia (HR,16.91; 95% CI,12.00-23.81), compared to non-HCV patients.

CONCLUSION: Individuals infected with HCV infection in U.S. are at greater risk of developing CKD, MPGN, and cryoglobulinemia. Minimally effective treatment of HCV infection can prevent the development of CKD, although the association was not significant for all-oral therapy. This article is protected by copyright. All rights reserved.

http://ift.tt/2x7MzqD