Hepatitis C Increases the Risk of Progression of Chronic Kidney Disease in Patients with Glomerulonephritis

Background/Aims: We have shown that hepatitis C does not increase the risk of developing chronic kidney disease (CKD), but it is not known if hepatitis C worsens progression of existing CKD. Methods: We retrospectively identified patients with primary glomerulonephritis on biopsy over 4 years, evaluating the progression of CKD over time. Results: The cohort consisted of 111 patients: 21% were positive for hepatitis C, 61% were negative for hepatitis C and 18% were not tested. The hepatitis C-positive subjects were more likely to be African American (p = 0.031), followed for fewer days (p = 0.007) and have diabetes and focal segmental glomerulosclerosis on biopsy (p ! 0.001). Longitudinal follow-up of CKD progression using multiple creatinine measures analyzed by repeated measures ANCOVA demonstrated that patients with hepatitis C had a worsening creatinine over time compared to the hepatitis C-negative and not tested groups (p ! 0.001). By Cox hazards regression analyses, risk of death/ end-stage renal disease (ESRD) was decreased in patients who tested negative for hepatitis C compared to testing positive (0.46, CI 0.27–0.88), but this became nonsignificant after adjustment for mean arterial pressure and hemoglobin. Received: April 15, 2010 Accepted: July 17, 2010 Published online: August 16, 2010 Nephrology American Journal of Sharon M. Moe, MD, Prof. of Medicine and Anatomy and Cell Biology Division of Nephrology, Vice-Chair for Research, Department of Medicine Indiana University School of Medicine 1001 W. 10th Street, OPW 526, Indianapolis, IN 46202 (USA) Tel. +1 317 278 2868, Fax +1 317 278 2860, E-Mail smoe @ iupui.edu © 2010 S. Karger AG, Basel Accessible online at: www.karger.com/ajn D ow nl oa de d by : 54 .1 91 .4 0. 80 4 /1 5/ 20 17 6 :2 9: 13 P M