title: Hepatitis C virus infection and glomerular disease.
abstract: The association between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) is well established and remains an area of intense research. HCV infection is associated with a large spectrum of histo-pathological lesions in both native and transplanted kidneys. The frequency of kidney damage in HCV-infected patients appears low even if is not fully detailed. The most frequent HCV-associated renal lesion is type I membrano-proliferative glomerulonephritis, usually in the context of type II mixed cryoglobulinemia. Various approaches have been tried for the treatment of HCV-related glomerulonephritis, including immunosuppressive therapy (corticosteroids and cytotoxic agents), plasma exchange and antiviral agents. Antiviral treatment of HCV-associated glomerulonephritis has shown encouraging results. Immunosuppressive therapy is particularly recommended for cryoglobulinemic kidney disease. Two distinct approaches should be considered for the treatment of HCV-associated cryoglobulinemic glomerulonephritis according to the level of proteinuria and kidney failure. Some evidence on rituximab therapy for HCV-related cryoglobulinemic glomerulonephritis exists but several questions related to its use need to be addressed.
authors.affiliation: Division of Nephrology, Ospedale Maggiore IRCCS Foundation, Milan, Italy - fabrizi@policlinico.mi.it.
authors.forename: F
authors.initials: F
authors.lastname: Fabrizi
authors.forename: F
authors.initials: F
authors.lastname: Donato
authors.forename: P
authors.initials: P
authors.lastname: Messa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003449:Cryoglobulinemia / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D005919:Glomerular Filtration Rate; D015432:Glomerulonephritis, Membranoproliferative / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D016030:Kidney Transplantation; D009395:Nephritis, Interstitial / Q000209:etiology; D011183:Postoperative Complications / Q000821:virology; D011507:Proteinuria / Q000209:etiology; D012367:RNA, Viral / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D000069283:Rituximab; D014766:Viremia / Q000150:complications
chemical_list: D000305:Adrenal Cortex Hormones; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D012367:RNA, Viral; D000069283:Rituximab; D007372:Interferons