Department of Occupation Medicine, Chang-Gung Memorial Hospital at Keelung, Keelung, Taiwan.
J Viral Hepat. 2014 Oct;21(10):706-15. doi: 10.1111/jvh.12199. Epub 2013 Dec 5.
Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages.
慢性肾脏病（CKD）是一个全球性的健康问题，带来了沉重的经济负担。慢性丙型肝炎病毒（HCV）感染是 CKD 的一个常见病因，它会显著影响 CKD 患者的进展和死亡率。这两种疾病在台湾的发病率都很高。本项多中心、基于人群的横断面研究共纳入 24642 名受试者，旨在探讨 HCV 感染与 CKD 患病率和严重程度的关系。比较了 HCV 血清阳性和阴性受试者的代谢参数、eGFR 和 CKD 分期的测量值。通过性别和年龄（≤45 岁和>45 岁）分析了 HCV 感染与 CKD 分期的关系，并评估了 CKD 的潜在危险因素。HCV 血清阳性受试者占 6.9%，年龄明显较大。HCV 血清阳性受试者的 CKD 患病率增加（16.5%）。HCV 血清阳性受试者的 CKD 分期≥3 的患病率明显较高（7.8%）。年龄（>45 岁）、男性、饮酒、高血压、肌酐和 HCV 感染是与 CKD 发生相关的显著因素。HCV 血清阳性是 CKD 发生的独立危险因素，与所有 CKD 分期的发生风险增加相关。CKD 早期阶段的高患病率需要进行纵向研究，频繁进行肾功能检测，并进行足够长的随访以确定 eGFR 随时间的变化。还需要对这些患者实施有效的治疗干预，以防止 CKD 进展到晚期。
