Hemodialysis prevents liver disease caused by hepatitis C virus: role of hepatocyte growth factor.
Hemodialysis prevents liver disease caused by hepatitis C virus: Role of hepatocyte growth factor.


BACKGROUND
Hemodialysis increases markedly the serum levels of hepatocyte growth factor (HGF) so that regular dialysis treatment (RDT) mimics the regular administration of HGF as a drug. Therefore, we have studied the effects of dialysis-associated HGF production on the severity of liver damage caused by hepatitis C virus (HCV).


METHODS
Biochemical tests of liver function and liver biopsy were performed in 10 patients on RDT and in 11 patients without renal disease (WRD) converted to anti-HCV serum-positive test for the same time (48 +/- 4 months). The HGF serum concentration was measured by enzyme immunoassay. In patients on RDT, HGF was measured just before starting a dialysis session (T0), at 15 and 240 minutes of dialysis (T15 and T240), and 24 hours later (T24 hr).


RESULTS
Serum HGF was similar in WRD (average 0.17 ng/ml) as in RDT at T0 (0.25 ng/ml). In RDT serum HGF increased markedly at T15 and T240 (5.51 and 2.67 ng/ml, respectively, P < 0. 001 vs. WRD and T0) and was still higher than baseline at T24 hr (0. 41 ng/ml, P < 0.05). Both grade of necroinflammatory activity and stage of fibrosis were significantly lower in RDT than in WRD (both, P < 0.001). The number of apoptotic hepatocytes was also significantly reduced in patients on RDT compared with patients WRD.


CONCLUSIONS
These results show that HCV-related liver disease is more benign in patients on RDT. The phenomenon may depend on the marked and prolonged HGF release caused by dialysis.
Rampino
T
T
Unità di Nefrologia e Dialisi and Servizio di Anatomia Patologica, Università ed IRCCS Ospedale San Matteo, Pavia, Italy. dalcanton@mbox.medit.it
Arbustini
E
E
Gregorini
M
M
Guallini
P
P
Libetta
C
C
Maggio
M
M
Ranghino
A
A
Silini
E
E
Soccio
G
G
Dal Canton
A
A
D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D006526:Hepatitis C / Q000473:pathology / Q000517:prevention & control*; D017228:Hepatocyte Growth Factor / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy* / Q000821:virology*; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014511:Uremia / Q000628:therapy / Q000821:virology; D019562:Viral Load
D017228:Hepatocyte Growth Factor; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase