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Management of Hepatitis C in Patients with Chronic Kidney Disease

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Abstract

Chronic kidney disease represents a global health problem. Chronic hepatitis C virus (HCV) infection is prevalent in patients with end stage renal disease (ESRD) on hemodialysis (HD) and in renal transplant recipients with significant impact on morbidity and mortality. Furthermore, HCV can cause various forms of glomerulopathy with the predominant type being cryglobulinemia associated membranoproliferative glomerulonephritis. Liver enzymes are traditionally used as markers of liver injury; however, there is wide variation in aminotransferase levels in patients with ESRD. Therefore, diagnosis of chronic hepatitis C (CHC) in patients with ESRD is based on HCV antibody testing and further confirmation with polymerase chain reaction testing. Current standard therapy for CHC is composed of pegylated interferon and ribavirin. However, this combination is challenging in patients with ESRD due to its tolerability. We describe in this review relevant issues in epidemiology, diagnosis and management of CHC in ESRD, HD and renal transplant recipients.

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  1. Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, United Kingdom

    Mohammad A. B. Al-Freah, Zeino Zeino & Michael A. Heneghan

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  1. Mohammad A. B. Al-Freah
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Al-Freah, M.A.B., Zeino, Z. & Heneghan, M.A. Management of Hepatitis C in Patients with Chronic Kidney Disease. Curr Gastroenterol Rep 14, 78–86 (2012). https://doi.org/10.1007/s11894-011-0238-0

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