Journal
DIGESTIVE DISEASES AND SCIENCES
Volume 61, Issue 7, Pages 2087-2093Publisher
SPRINGER
DOI: 10.1007/s10620-016-4199-x
Keywords
Hepatitis C; Renal disease; Glomerular filtration rate; Hepatic fibrosis
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Funding
- CDC Foundation
- AbbVie
- Genentech, A Member of the Roche Group
- Gilead Sciences
- Janssen Pharmaceuticals, Inc.
- Vertex Pharmaceuticals
- Bristol-Myers Squibb
- Henry Ford Health System
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Guidelines for the treatment of HCV-infected persons were updated in August 2015 with new recommendations for patients with renal impairment. Treatment is imperative for patients with severe, renal-associated extrahepatic manifestations of HCV infection. We sought to describe the prevalence of these conditions among current HCV-infected patients in a population-based prospective, observational cohort study at four large US health systems. Data from cohort patients with chronic HCV infection during 2012 were analyzed for the period from 2006 to 2013. We determined the prevalence of mild to moderately impaired renal function defined as having the most recent estimated glomerular filtration rate [eGFR] a parts per thousand currency sign 80 ml/min/1.73 m(2), with severe impairment defined as eGFR < 30 ml/min/1.73 m(2), based on the treatment guidelines. Prevalence of extrahepatic conditions was ascertained using ICD9-codes. Among 5772 persons, the prevalence of eGFR a parts per thousand currency sign 80 was 33 % and eGFR < 30 was 2 %, including among patients with hepatic fibrosis. Diagnosed extrahepatic renal manifestations were rare: vasculitis- 0.2 %, nephrotic syndrome- 0.3 %, and cryoglobulinemia- 0.9 %. While the prevalence of severe renal impairment and diagnosed extrahepatic manifestations was low, mild-to-moderate renal impairment was common in HCV patients, including those with advanced liver fibrosis for whom the need for treatment is urgent.
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