Hepatitis C is a predictor of poorer renal survival in diabetic patients.
OBJECTIVE
Hepatitis C virus (HCV) is highly prevalent in the U.S. and worsens renal survival in some kidney diseases. We examined the effects of HCV on renal survival in diabetic patients with renal disease.


METHODS
HCV and diabetes status were noted in patients seen in our nephrology clinic in 2001 and 2002. Charts of diabetic patients were reviewed for demographics, blood pressure, renal function, medicines, the presence of HCV, and other factors at the initial visit and over follow-up. The effect of HCV on renal survival was determined by Cox proportional hazards, using end-stage renal disease (ESRD) as an end point.


RESULTS
Of 1,127 patients, prevalence rates for HCV were higher in African Americans than non-African Americans (8.09 vs. 3.93%, respectively, P = 0.06), with African-American men having the highest prevalence rates (12.7%). The charts of 312 diabetic patients were reviewed. Over 80% were African American, as were 23 of 24 patients with HCV. Compared with non-HCV patients, HCV patients were younger, had higher diastolic blood pressure, and had lower BMI. HCV patients had significantly worse cumulative renal survival by Kaplan-Meier. On Cox proportional hazards analysis, HCV was a significant predictor of reaching ESRD independent of initial renal function, proteinuria, blood pressure, sex, race, presence of diabetic nephropathy, age, or duration of diabetes (odds ratio 3.49, 95% CI 1.27-9.57, P = 0.015).


CONCLUSIONS
HCV is common in African Americans with diabetes and renal disease and is an independent risk factor for renal survival in this population. Prospective studies are necessary to confirm these observations.
Crook
Errol D
ED
Department of Internal Medicine, Division of Nephrology, Wayne State University School of Medicine, Detroit, Michigan. ecrook@usouthal.edu
Penumalee
Sreelatha
S
Gavini
Bharathi
B
Filippova
Kseniya
K
D017668:Age of Onset; D000704:Analysis of Variance; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality; D003928:Diabetic Nephropathies / Q000150:complications / Q000401:mortality*; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis