Hepatitis C increases the risk of progression of chronic kidney disease in patients with glomerulonephritis.
OBJECTIVE
We have shown that hepatitis C does not increase the risk of developing chronic kidney disease (CKD), but it is not known if hepatitis C worsens progression of existing CKD.


METHODS
We retrospectively identified patients with primary glomerulonephritis on biopsy over 4 years, evaluating the progression of CKD over time.


RESULTS
The cohort consisted of 111 patients: 21% were positive for hepatitis C, 61% were negative for hepatitis C and 18% were not tested. The hepatitis C-positive subjects were more likely to be African American (p = 0.031), followed for fewer days (p = 0.007) and have diabetes and focal segmental glomerulosclerosis on biopsy (p < 0.001). Longitudinal follow-up of CKD progression using multiple creatinine measures analyzed by repeated measures ANCOVA demonstrated that patients with hepatitis C had a worsening creatinine over time compared to the hepatitis C-negative and not tested groups (p < 0.001). By Cox hazards regression analyses, risk of death/end-stage renal disease (ESRD) was decreased in patients who tested negative for hepatitis C compared to testing positive (0.46, CI 0.27-0.88), but this became nonsignificant after adjustment for mean arterial pressure and hemoglobin.


CONCLUSIONS
Our results support that infection with hepatitis C in patients with glomerulonephritis is associated with an increased risk of progression of CKD. Prospective studies are required to confirm these observations.
Noureddine
Lama A
LA
Indiana University School of Medicine, Indianapolis, 46202, USA.
Usman
Sohail A
SA
Yu
Zhangsheng
Z
Moorthi
Ranjani N
RN
Moe
Sharon M
SM
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000378:metabolism* / Q000473:pathology*; D006526:Hepatitis C / Q000150:complications* / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000378:metabolism / Q000503:physiopathology*; D012189:Retrospective Studies; D012306:Risk
D003404:Creatinine