Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease.

Abstract

Hepatitis C virus (HCV) is associated with renal complications. We aimed to determine whether a sustained virological response (SVR) was associated with improvements in renal function (RF) in liver transplant (LT) recipients treated for HCV. Changes in RF were compared 1, 3, and 5 years after therapy as a function of the stage of chronic kidney disease (CKD) before treatment (BT). Variables associated with renal dysfunction [RD; 4-variable Modification of Diet in Renal Disease (MDRD-4) value 60 mL/minute] at the last follow-up (LFU) were evaluated for all treated LT patients with a minimum follow-up of at least 1 year since the end of treatment (EOT; n = 175). There were 99 patients with stage 2 CKD BT (MDRD-4 value 60-89 mL/minute/1.73 m(2) ), and an improvement in RF was observed more frequently among SVR patients versus nonresponders (NRs). The median changes in the MDRD-4 values BT to 1, 3, and 5 years after treatment were -0.5, 4.5, and 9.4 mL/minute for the SVR patients and -1, -0.3, and -1.5 mL/minute for the NRs (P = 0.61, P = 0.06, and P = 0.004, respectively). RD was present in 31% of the patients at the LFU at a median of 3.8 years after EOT (range 1-9 years). The follow-up did not differ between SVR patients and NRs. RD was present at the LFU in 19% of SVR patients versus 40% of NRs (P = 0.002). In the multivariate analysis, RD at the LFU was associated with NRs [relative risk (RR) 3.8, 95% confidence interval (CI)  = 1.3-11.23, P = 0.01], EOT MDRD-4 values (RR = 1.022, 95% CI = 1.001-1.04, P = 0.04), and female sex (RR = 5.6, 95% CI = 1.84-17.5, P = 0.002). In conclusion, SVR leads to improved RF in HCV-infected LT recipients with stage 2 CKD BT.

• Authors: Michel Blé, Victoria Aguilera, Angel Rubín, María García-Eliz, Carmen Vinaixa, Martín Prieto, Marina Berenguer
• Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 20 Issue 1 Pg. 25-34 (Jan 2014) ISSN: 1527-6473 [Electronic] United States
• PMID: 24115296 (Publication Type: Journal Article)
• Copyright: © 2013 American Association for the Study of Liver Diseases.

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• peginterferon alfa-2b

Topics

• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (chemistry, therapeutic use)
• Female
• Follow-Up Studies
• Hepacivirus
• Hepatitis C (complications, therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Kidney (physiology)
• Kidney Function Tests
• Liver Transplantation
• Male
• Middle Aged
• Multivariate Analysis
• Polyethylene Glycols (therapeutic use)
• Recombinant Proteins (therapeutic use)
• Renal Insufficiency
• Renal Insufficiency, Chronic (complications, physiopathology)
• Time Factors
• Treatment Outcome