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Hepatitis C and kidney disease: A narrative review

Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immunecomplexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis. HCV-infected patients are at increased risk of acute post-transplant complications. Long-term graft survival is compromised by recurrent or de novo glomerulonephritis, or chronic transplant glomerulopathy. Patient survival is challenged by increased incidence of diabetes, sepsis, post-transplant lymphoproliferative disease, and liver failure. Effective and safe directly acting antiviral agents (DAAs) are currently available for treatment at different stages of kidney disease. However, the relative shortage of DAAs in countries where HCV is highly endemic imposes a need for treatmentprioritization, for which a scoring system is proposed in this review. It is concluded that the thoughtful use of DAAs, will result in a significant change in the epidemiology and clinical profiles of kidney disease, as well as improvement of dialysis and transplant outcomes, in endemic areas. | Journal of Advanced Research 2017 8 113-130 Cairo University Journal of Advanced Research REVIEW Hepatitis C and kidney disease A narrative review CrossMark Rashad S. Barsoum a b Emad A. Williamb c Soha S. Khalilb aKasr-El-Aini Medical School Cairo University Cairo Egypt b The Cairo Kidney Center Cairo Egypt c National Research Centre Cairo Egypt GRAPHICAL ABSTRACT failure Cardiovascular events Autoimmunity v Direct Cytotoxic Cryoglobulins Ị . A . 1 Glomerulonephritis Acute graft injury Chronic Tx glomerulopathy De-novo recurrent GN sepsis NODAT PTLD Liver failure ARTICLE INFO ABSTRACT Article history Received 19 April 2016 Received in revised form 7 July 2016 Accepted 17 July 2016 Available online 26 July 2016 Keywords Acute kidney injury Chronic kidney disease Glomerulonephritis Hepatitis-C HCV infection can induce kidney injury mostly due to formation of immune-complexes and cryoglobulins and possibly to a direct cytopathic effect. It may cause acute kidney injury AKI as a part of systemic vasculitis and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis. HCV-infected patients are at increased risk of acute post-transplant complications. Long-term graft survival is compromised by recurrent or de novo glomerulonephritis or chronic transplant glomerulopathy. Patient survival is challenged by increased incidence of diabetes sepsis post-transplant lymphoproliferative disease and liver failure. Effective and safe directly acting antiviral agents DAAs Corresponding author. Fax 20 225790267. E-mail address Rashad.barsoum@gmail.com R.S. Barsoum . Peer review under responsibility of Cairo University. Production and hosting by Elsevier http dx.doi.org 10.1016 jjare.2016.07.004 2090-1232 2016 Production and hosting by Elsevier