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Hepatitis C virus infection and the prevalence of renal insufficiency

Dalrymple LS, Koepsell T, Sampson J, Louie T, Dominitz JA, Young B, Kestenbaum B. Hepatitis C virus infection and the prevalence of renal insufficiency. Clinical Journal of the American Society of Nephrology. 2007 Jul 1; 2(4):715-21.

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BACKGROUND: Hepatitis C virus (HCV) is associated with pathologic changes in the kidney. However, the association between HCV and renal dysfunction is not well defined. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: This study estimated the prevalence of renal insufficiency among veterans who received care through the Veterans Affairs Puget Sound Health Care System. The study population consisted of veterans who underwent HCV antibody testing between January 1, 1999, and December 31, 2004, and had at least one primary care or medical subspecialty visit and at least one outpatient creatinine measurement within the 18 mo before antibody testing. Veterans were excluded when they had a history of chronic dialysis, creatinine > 5 mg/dl, or renal transplantation. Study data were extracted from the electronic medical record. Renal insufficiency was defined as a creatinine level > or = 1.5 mg/dl. Multivariate logistic regression was performed to estimate the risk for renal insufficiency associated with HCV. Among 25,782 eligible veterans, 1928 were HCV antibody positive and 23,854 were HCV antibody negative. RESULTS: Although the proportion with renal insufficiency was lower for antibody-positive versus -negative veterans (4.8 versus 6.0%), after adjustment for age, race, gender, diabetes, and hypertension, HCV-positive veterans had a 40% higher odds for renal insufficiency (odds ratio 1.40; 95% confidence interval 1.11 to 1.76) as compared with HCV-negative veterans. CONCLUSIONS: HCV was associated with an increased prevalence of renal insufficiency.

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