Renal complications of liver diseases

Expert Rev Gastroenterol Hepatol. 2018 Nov;12(11):1135-1142. doi: 10.1080/17474124.2018.1530984. Epub 2018 Oct 11.

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the major causes of chronic liver disease. HBV and HCV affect nearly 7% of the world's population. Extra-hepatic complications and particularly renal failure have different mechanisms and manifestations. The underlying mechanism, although differing for each disease, mainly involves the immune system and antibody deposits in the kidney, which can lead to tissue damage. Areas covered: We do not cover in this review hepatorenal syndrome. We report on the renal complications of viral hepatitis (HBV, HCV, hepatitis E), autoimmune hepatitis, cirrhosis, and Wilson's disease. The most frequent renal disorders are those related to HBV, and HCV due to their high prevalence worldwide. Expert commentary: Thanks to generalization of vaccination against HBV, prevalence of HBV-related liver diseases will decrease, and thereby its associated renal involvement such as polyarteritis nodosa (an exceptional condition), and glomerulonephritis such as membranous nephropathy. Thanks to direct acting antiviral agents HCV infection will be cured within the next decade. However, HCV-related cryoglobulinemia with or without renal involvement might evolve on its own after the patient has eliminated HCV, necessitating then rituximab therapy. Conversely, orofecal-transmitted hepatitis viruses such as hepatitis A and hepatitis E are still very prevalent in developing countries; however, they are rarely associated with renal manifestations.

Keywords: Kidney failure; glomerulonephritis; hepatitis; hepatitis B; hepatitis C; kidney transplantation.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Hepatitis B Vaccines / therapeutic use
  • Hepatitis, Autoimmune* / diagnosis
  • Hepatitis, Autoimmune* / epidemiology
  • Hepatitis, Autoimmune* / therapy
  • Hepatitis, Viral, Human* / diagnosis
  • Hepatitis, Viral, Human* / epidemiology
  • Hepatitis, Viral, Human* / therapy
  • Hepatolenticular Degeneration* / diagnosis
  • Hepatolenticular Degeneration* / epidemiology
  • Hepatolenticular Degeneration* / therapy
  • Humans
  • Kidney Diseases* / diagnosis
  • Kidney Diseases* / epidemiology
  • Kidney Diseases* / therapy
  • Kidney Transplantation
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / epidemiology
  • Liver Cirrhosis* / therapy
  • Risk Factors
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Hepatitis B Vaccines