title: Association of reduced renal function with hepatitis B virus infection and elevated alanine aminotransferase.
abstract: OBJECTIVE
  Clinically, hepatitis B virus (HBV) infection is observed to be associated with nephropathy. However, previous population-based studies failed to show an association between HBV infection and CKD. Therefore, this cross-sectional study was designed to further explore this association.
  
  
  METHODS
  A representative sample of 6854 Chinese adults aged 30-75 years was tested for levels of serum hepatitis B surface antigen, alanine aminotransferase (ALT), creatinine, urinary albumin/creatinine ratio, and potential CKD risk factors.
  
  
  RESULTS
  Neither HBV infection nor elevated ALT (ALT+; ≥ sex-specific 90th percentile of ALT levels of noninfected persons) was significantly associated with reduced estimated GFR (eGFR < 60 ml/min per 1.73 m(2)). Compared with noninfected persons, HBV-infected persons with ALT+, but not those with ALT- (P=0.26), were more likely to have reduced eGFR (odds ratio, 4.07; 95% confidence interval, 1.18-14.0; P=0.03). Further analysis with a general linear model revealed a significant difference in eGFR (mean ± SEM) between HBV-infected and noninfected persons (87.8±0.8 versus 90.2±0.4 ml/min per 1.73 m(2); P=0.002). This difference was mainly derived from that between HBV-infected persons with ALT+ and noninfected persons, with an average difference in eGFR of -4.5 (95% confidence interval, -0.9 to -8.1; P=0.01). HBV infection and ALT+, alone or in combination, were not significantly associated with albuminuria or CKD.
  
  
  CONCLUSIONS
  HBV infection with elevated ALT, rather than HBV infection alone, was associated with reduced renal function.
authors.affiliation: Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Cai
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Fan
authors.forename: Lijun
authors.initials: L
authors.lastname: Mou
authors.forename: Bixia
authors.initials: B
authors.lastname: Gao
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Liu
authors.forename: Jinhong
authors.initials: J
authors.lastname: Li
authors.forename: Lili
authors.initials: L
authors.lastname: Liu
authors.forename: Haiyun
authors.initials: H
authors.lastname: Wang
authors.forename: Zengyu
authors.initials: Z
authors.lastname: Guo
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Liu
authors.forename: Hang
authors.initials: H
authors.lastname: Li
authors.forename: Xuemei
authors.initials: X
authors.lastname: Li
authors.forename: Xuewang
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000419:Albuminuria / Q000097:blood / Q000201:enzymology / Q000503:physiopathology / Q000821:virology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology* / Q000503:physiopathology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology* / Q000503:physiopathology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D003404:Creatinine; D000410:Alanine Transaminase