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World J Hepatol. Jan 27, 2015; 7(1): 78-92
Published online Jan 27, 2015. doi: 10.4254/wjh.v7.i1.78
Hepatitis C and kidney disease: An overview and approach to management
Ahmad Najib Azmi, Soek-Siam Tan, Rosmawati Mohamed
Ahmad Najib Azmi, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur 55100, Malaysia
Soek-Siam Tan, Department of Hepatology, Selayang Hospital, Selangor 68100, Malaysia
Rosmawati Mohamed, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
Author contributions: Azmi AN, Tan SS and Mohamed R equally contributed to the present work; Azmi AN drafted, wrote, edited and revised the article; Tan SS and Mohamed R equally contributed to revising, editing and writing the article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmad Najib Azmi, MBBS, MMed, Senior Lecturer, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, 13th Floor, Menara B, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur 55100, Malaysia. najibaz@usim.edu.my
Telephone: +60-3-42892400 Fax: +60-3-42892477
Received: September 4, 2014
Peer-review started: September 5, 2014
First decision: September 28, 2014
Revised: October 13, 2014
Accepted: November 7, 2014
Article in press: November 10, 2014
Published online: January 27, 2015
Processing time: 128 Days and 2.9 Hours
Abstract

Hepatitis C infection and chronic kidney disease are major health burden worldwide. Hepatitis C infection is associated with a wide range of extra-hepatic manifestations in various organs including the kidneys. A strong association between hepatitis C and chronic kidney disease has come to light. Hemodialysis in supporting the end stage renal disease patients unfortunately carries a risk for hepatitis C infection. Despite much improvement in the care of this group of patients, the prevalence of hepatitis C infection in hemodialysis patients is still higher than the general population. Hepatitis C infection has a negative effect on the survival of hemodialysis and renal transplant patients. Treatment of hepatitis C in end stage renal disease patients using conventional or pegylated interferon with or without ribavirin remains a clinical challenge with low response rate, high dropout rate due to poor tolerability and many unmet needs. The approval of new direct acting antiviral agents for hepatitis C may dramatically change the treatment approach in hepatitis C infected patients with mild to moderate renal impairment. However it remains to be confirmed if the newer Hepatitis C therapies are safe in individuals with severe renal impairment. This review article discusses the relationship between hepatitis C and chronic kidney disease, describe the various types of renal diseases associated with hepatitis C and the newer as well as the existing treatments for hepatitis C in the context of this subpopulation of hepatitis C patients.

Keywords: Chronic hepatitis C; Kidney disease; Management

Core tip: There is a strong association between hepatitis C virus (HCV) infection and chronic kidney disease with negative impact on survival in hemodialysis and post renal transplant HCV infected patients. Recent data showed that treatment of HCV improves outcomes. In HCV infected diabetics, effective anti-HCV treatment reduces the incidence of end stage renal disease. There are now major advances in HCV treatment which may dramatically change the treatment approach in hepatitis C infected patients.