title: Incidence and Progression of Chronic Kidney Disease After Hepatitis C Seroconversion: Results from ERCHIVES.
abstract: OBJECTIVE
  We aimed to assess the incidence and progression of chronic kidney disease (CKD) following hepatitis C virus (HCV) seroconversion.
  
  
  METHODS
  This retrospective cohort study included Veterans with a confirmed HCV seroconversion between 2001 and 2014 and Veterans with negative HCV testing over the same time period. The outcomes included development of advanced CKD (eGFR < 60 mL/min/1.73 m(2) on two separate occasions at least 90 days apart, plus a ≥ 10 mL/min/1.73 m(2) decline from baseline) and progressive CKD (decline in eGFR of ≥ 30 mL/min/1.73 m(2) from baseline). Multivariable Cox proportional hazards models were used to evaluate the association between HCV and incident advanced and progressive CKD.
  
  
  RESULTS
  The final cohort consisted of 71,528 Veterans, including 2589 with recently seroconverted HCV. Over a mean follow-up of 6 years, 36% of patients with and 31% without HCV developed advanced CKD (p < 0.001), and 35% of patients with vs. 26% without HCV developed progressive CKD (p < 0.001). After controlling for traditional risk factors, recently seroconverted HCV+ patients were significantly less likely to develop advanced CKD (HR 0.86; 95% CI 0.79, 0.92), and HCV status was not significantly associated with progressive CKD (HR 0.93; 95% CI 0.86, 1.00). Factors associated with developing advanced and progressive CKD included older age, female sex, diabetes, hypertension, development of cirrhosis, and substance abuse.
  
  
  CONCLUSIONS
  In this cohort of newly infected US Veterans, HCV infection was associated with decreased incidence of advanced and unchanged risk of progressive CKD, suggesting a larger role for traditional risk factors in the development of CKD after HCV seroconversion.
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA, 15240, USA. rogalss@upmc.edu.|Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA. rogalss@upmc.edu.
authors.forename: Shari S
authors.identifier: http://orcid.org/0000-0001-8184-1546
authors.initials: SS
authors.lastname: Rogal
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA, 15240, USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Yan
authors.affiliation: Atlanta VA Medical Center, Decatur, GA, USA.|Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lo Re
authors.affiliation: Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Hind
authors.initials: H
authors.lastname: Al-Rowais
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA, 15240, USA.|School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Fried
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA, 15240, USA.|School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.|Hamad Medical Corporation, Doha, Qatar.|Hamad Healthcare Quality Institute, Doha, Qatar.
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D000069078:Seroconversion; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D019562:Viral Load
chemical_list: D012367:RNA, Viral
keywords: CKD; HCV; Progressive CKD