title: Hepatitis C in chronic kidney disease: predialysis patients present more severe histological liver injury than hemodialysis patients?
abstract: BACKGROUND
  The characteristics of hepatitis C virus (HCV) infection in predialysis patients are poorly understood and they could be different from hemodialysis patients.
  
  
  OBJECTIVE
  To evaluate the demographics, laboratory and histological characteristics of chronic HCV infection in predialysis patients and to compare them with those observed in hemodialysis patients.
  
  
  METHODS
  Thirty-nine predialysis patients with chronic HCV infection were compared to HCV-infected hemodialysis patients (ratio of 1:3) in terms of demographics, laboratory and histological characteristics. The fibrosis progression rate (FPR) was calculated as the ratio between fibrosis stage and duration of infection.
  
  
  RESULTS
  Predialysis patients were older (57 +/- 10 vs. 45 +/- 12 years; p < 0.001), presented a higher proportion of elevated alanine aminotransferase (71.8 vs. 41.0%; p = 0.001) and aspartate aminotransferase (64.1 vs. 26.5%; p < 0.001), a higher proportion of interface hepatitis (66.7 vs. 47%; p = 0.033) and more advanced fibrosis (71.8 vs. 16.2%; p = 0.001). Among patients with estimated duration of infection, predialysis patients presented a longer duration of infection (22 vs. 6 years; p < 0.001) and no difference in FPR was observed between groups (p = 0.692).
  
  
  CONCLUSIONS
  Although predialysis patients with HCV infection present more severe histological injury than hemodialysis patients, this finding probably reflects a longer duration of infection with no evidence supporting that hepatitis C presents a more aggressive course in this group.
authors.affiliation: Division of Gastroenterology, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Lara B
authors.initials: LB
authors.lastname: Lemos
authors.forename: Renata M
authors.initials: RM
authors.lastname: Perez
authors.forename: Marcelo M
authors.initials: MM
authors.lastname: Lemos
authors.forename: Valéria P
authors.initials: VP
authors.lastname: Lanzoni
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Draibe
authors.forename: Ivonete S
authors.initials: IS
authors.lastname: Silva
authors.forename: Antonio Eduardo B
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia G
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis