Kamimura Hiroteru, Setsu Toru, Kimura Naruhiro, Yokoo Takeshi, Sakamaki Akira, Kamimura Kenya, Tsuchiya Atsunori, Takamura Masaaki, Yamagiwa Satoshi, Terai Shuji
Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Diseases. 2018 Jun 19;6(2):52. doi: 10.3390/diseases6020052.
The liver plays a key role in the metabolism of proteins. Liver dysfunction affects many organs because it communicates with the spleen and all digestive organs through the portal vein. Additionally, the kidney is an organ that is closely related to the liver and is involved in liver diseases. Glomerulonephritis is an important extrahepatic manifestation of chronic hepatitis B virus (HBV) infection. Nucleos(t)ide analog (NA) therapy effectively suppresses HBV replication by inhibiting HBV polymerase, thus decreasing the levels of serum HBV-DNA and delaying the progression of cirrhosis. Although NA therapy is recommended for all patients with chronic HBV infection, regardless of the level of renal dysfunction, there is limited information on NA use in patients with chronic kidney disease. In addition, in patients with end-stage liver cirrhosis, hepatorenal syndrome can be fatal. Hence, we should take into account the stage of impaired renal function in patients with cirrhosis. The aims of this article are to review the epidemiology, clinical presentation, treatment, and prevention of HBV-associated nephropathy.
肝脏在蛋白质代谢中起关键作用。肝功能障碍会影响许多器官，因为它通过门静脉与脾脏和所有消化器官相互联系。此外，肾脏是与肝脏密切相关且参与肝脏疾病的器官。肾小球肾炎是慢性乙型肝炎病毒（HBV）感染的一种重要肝外表现。核苷（酸）类似物（NA）疗法通过抑制HBV聚合酶有效抑制HBV复制，从而降低血清HBV-DNA水平并延缓肝硬化进展。尽管推荐所有慢性HBV感染患者使用NA疗法，无论其肾功能不全程度如何，但关于慢性肾脏病患者使用NA的信息有限。此外，在终末期肝硬化患者中，肝肾综合征可能是致命的。因此，我们应该考虑肝硬化患者肾功能损害的阶段。本文的目的是综述HBV相关性肾病的流行病学、临床表现、治疗及预防。
