title: Hepatitis C virus-related kidney disease: various histological patterns.
abstract: BACKGROUND
  Although hepatitis C virus (HCV) infection is known to be associated with Type 2 cryoglobulinemic glomerulopathy (CG), only a few reports about other types of nephropathy have been published.
  
  
  METHODS
  68 HCV antibody positive patients in whom renal biopsy had been performed for persistent proteinuria, hematuria, and/or renal dysfunction between 1992 and 2008 at our institute were included. The histological, clinical and laboratory characteristics including the age, gender, hypertension, diabetes mellitus, liver histology (chronic hepatitis or liver cirrhosis), HCV-RNA, HCV genotype, splenomegaly, gastroesophageal varices, serum creatinine, hemoglobin, platelet count, rheumatoid factor, cryoglobulin, IgG, IgA, IgM, CH50, C3, C4, creatinine clearance, 24-h protein excretion, and hematuria, between their nephropathy with and without immune deposition were compared.
  
  
  RESULTS
  Nephropathy was classified into two groups based on the detection of immune deposits by immunofluorescence microscopy: i.e., a positive group (n = 39) and a negative group (n = 29). The former group was further classified into three types of nephropathy: IgG dominant group (n = 10) (including membranous nephropathy (MN)), IgA dominant group (n = 20) (including IgA nephropathy (IgAN)), membranoproliferative glomerulonephritis (MPGN) (IgA type)), and IgM dominant group (n = 9) (MPGN apart from the IgA type). The latter group included diabetic nephropathy (n = 13), focal glomerular sclerosis (n = 4), and benign nephrosclerosis (n = 3), malignant nephrosclerosis (n = 1), tubulointerstitial nephritis (TIN) (n = 2), minimal change nephrotic syndrome (n = 1), cast nephropathy (n = 1), granulomatous TIN (n = 1), and others (n = 3). An increased serum IgM level, hypocomplementemia, splenomegaly, thrombocytopenia, liver cirrhosis, hematuria, and a high HCV RNA level were features of patients with MPGN of IgM dominant group (consistent with "CG").
  
  
  CONCLUSIONS
  Our results showed various histological patterns of HCV-related kidney disease and the specificity of CG, and revealed that a minority of HCV patients (n = 7) presented typical CG, while IgAN, MN, and diabetic nephropathy were more frequent.
authors.affiliation: Nephrology Center and Department of Pathology, Toranomon Hospital Kajigaya, Kanagawa, Japan. k_sumida0504@yahoo.co.jp
authors.forename: K
authors.initials: K
authors.lastname: Sumida
authors.forename: Y
authors.initials: Y
authors.lastname: Ubara
authors.forename: J
authors.initials: J
authors.lastname: Hoshino
authors.forename: T
authors.initials: T
authors.lastname: Suwabe
authors.forename: S
authors.initials: S
authors.lastname: Nakanishi
authors.forename: R
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: E
authors.initials: E
authors.lastname: Hasegawa
authors.forename: N
authors.initials: N
authors.lastname: Hayami
authors.forename: M
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: N
authors.initials: N
authors.lastname: Sawa
authors.forename: F
authors.initials: F
authors.lastname: Takemoto
authors.forename: K
authors.initials: K
authors.lastname: Takaichi
authors.forename: K
authors.initials: K
authors.lastname: Oohashi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D003165:Complement System Proteins / Q000032:analysis; D003449:Cryoglobulinemia / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003928:Diabetic Nephropathies / Q000473:pathology / Q000821:virology; D005260:Female; D005922:Glomerulonephritis, IGA / Q000473:pathology / Q000821:virology; D015432:Glomerulonephritis, Membranoproliferative / Q000473:pathology / Q000821:virology; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology / Q000821:virology; D006417:Hematuria / Q000473:pathology / Q000821:virology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007564:Japan; D007674:Kidney Diseases / Q000145:classification / Q000276:immunology / Q000473:pathology* / Q000628:therapy / Q000821:virology; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000473:pathology / Q000821:virology; D009402:Nephrosis, Lipoid / Q000473:pathology / Q000821:virology; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000473:pathology / Q000821:virology; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D003165:Complement System Proteins