Clinical

HCV seropositivity predisposes patients to end-stage renal disease

Last Updated: 2007-06-26 11:17:13 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Adults seropositive for hepatitis C virus (HCV) are at increased risk for developing end-stage renal disease (ESRD), investigators in San Francisco report in the June 25th issue of the Archives of Internal Medicine.

The liver is not the only organ affected by HCV, Dr. Judith I. Tsui and her associates note. Even so, they say, the risk for clinically significant renal outcomes is not known.

Dr. Tsui, from the Veterans Affairs Medical Center, and her team linked data from Medicare, the Department of Veterans Affairs, and the United States Renal Data System. Their goal was to see if HCV infection was associated with treated ESRD, defined as hemodialysis or kidney transplantation.

Their study cohort included veterans who had undergone at least 1 serum creatinine measurement within the VA between October 2000 and September 2001. The analytic cohort included 474,000 who were tested for HCV within 1 year of the creatinine test, of whom 53,000 tested positive. Subjects were followed until October 2004.

Among those with an estimated glomerular filtration rate of at least 30 mL/min per 1.73 meter squared, the adjusted hazard rate was 2.80 for ESRD among those that were HCV-positive.

"The effect was only was only present in patients younger than 70 years and was stronger for patients with normal or somewhat preserved renal function," the authors report.

However, once ESRD became established, progression was more rapid among patients that were HCV-positive.

"Patients with HCV are more likely to experience rapid decline in renal function," the authors conclude.

Arch Intern Med 2007;167:1271-1276.