慢性丙型肝炎病毒感染患者的急性肾功能障碍：病毒和非病毒因素分析
Acute Kidney Dysfunction in Patients with Chronic Hepatitis C Virus Infection: Analysis of Viral and Non-viral Factors.
作者信息
Satapathy Sanjaya K, Lingisetty Chandra S, Williams Susan E
机构信息
Department of Medicine, New York Medical College, Metropolitan Hospital Center, 1901 First Avenue, New York 10029, NY, USA ; Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN 38014, USA.
Department of Medicine, New York Medical College, Metropolitan Hospital Center, 1901 First Avenue, New York 10029, NY, USA.
出版信息
J Clin Exp Hepatol. 2014 Mar;4(1):8-13. doi: 10.1016/j.jceh.2014.01.004. Epub 2014 Feb 20.
BACKGROUND
Multiple studies have shown a relationship between chronic hepatitis C infection and chronic kidney disease. The prevalence, severity, underlying etiologies and predictors of acute kidney dysfunction (AKD) events in patients with hepatitis C has not been studied.
METHODS
We investigated viral and non-viral factors in the development renal dysfunction in 468 HCV patients retrospectively over a period of observation ranging from 3 months to 6 yrs.
RESULTS
A total of 124 AKD events occurred in 63 patients. On regression analysis; gender, race, alcohol abuse, HIV (Human immune deficiency virus) status, body mass index, baseline viral load (HCV-PCR), and genotype did not predict an event of AKD. Decompensated liver disease, history of IVDU, diabetes mellitus and baseline creatinine were independent predictors of AKD.
CONCLUSION
Development of AKD in patient with hepatitis C virus infection is independent of the genotype and viral load at baseline and is mostly predisposed by known prevalent factors in patients with hepatitis C such as diabetes, hypertension and intravenous drug use. Decompensated liver disease is the single most viral-related factor that predisposes for AKD.
背景
多项研究表明慢性丙型肝炎感染与慢性肾脏病之间存在关联。丙型肝炎患者急性肾功能障碍（AKD）事件的发生率、严重程度、潜在病因及预测因素尚未得到研究。
方法
我们对468例丙型肝炎病毒（HCV）患者进行了为期3个月至6年的回顾性观察，调查了肾功能不全发生过程中的病毒和非病毒因素。
结果
63例患者共发生124次AKD事件。回归分析显示，性别、种族、酗酒、HIV（人类免疫缺陷病毒）感染状况、体重指数、基线病毒载量（HCV-PCR）和基因型不能预测AKD事件。失代偿期肝病、静脉注射毒品史、糖尿病和基线肌酐水平是AKD的独立预测因素。
结论
丙型肝炎病毒感染患者发生AKD与基线时的基因型和病毒载量无关，主要由丙型肝炎患者中已知的常见因素如糖尿病、高血压和静脉吸毒所致。失代偿期肝病是导致AKD的最主要病毒相关因素。
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