HCV infection and the incidence of CKD

Am J Kidney Dis. 2011 Mar;57(3):396-402. doi: 10.1053/j.ajkd.2010.09.023. Epub 2010 Dec 24.

Abstract

Background: The risk of hepatitis C virus (HCV) infection upon incident chronic kidney disease (CKD) in the presence of traditional risk factors and renal-modifying therapy is not well known.

Study design: National cohort study.

Setting & participants: HCV-infected and -uninfected veterans in ERCHIVES (Electronically Retrieved Cohort of HCV Infected Veterans) in 2001-2006.

Predictor: HCV infection.

Outcomes: Incident CKD stages 3-5.

Results: We identified 18,002 patients with HCV infection and 25,137 controls with estimated glomerular filtration rate >60 mL/min/1.73 m(2) at baseline. HCV-infected patients had a lower prevalence of several CKD risk factors, including diabetes (22.9% vs 26.6%), hypertension (52.4% vs 60.8%), and dyslipidemia (39.3% vs 73.9%; P < 0.001). HCV infection was associated with a higher risk of developing CKD stages 3-5 (HR, 1.30; 95% CI, 1.23-1.37). Increasing age, hypertension, and diabetes were associated with significantly higher risks of developing CKD in HCV-infected patients and controls. Decompensated liver disease was a strong predictor of CKD in HCV-infected patients (HR, 3.37; 95% CI, 3.10-3.66) and HCV-uninfected controls (HR, 2.04; 95% CI, 1.84-2.25). In Kaplan-Meier analysis, HCV-infected persons had a shorter time to CKD.

Limitations: Lack of proteinuria data; small number of women.

Conclusions: HCV infection is associated with higher risk and shorter time to CKD despite having a lower prevalence of many CKD risk factors. HCV-infected persons should have targeted monitoring for the development and progression of CKD.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Female
  • Glomerular Filtration Rate
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / physiopathology
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • United States / epidemiology
  • Veterans