Gordon Craig E, Balk Ethan M, Francis Jean M
Division of Nephrology, Tufts Medical Center, Boston, Massachusetts.
Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island.
Semin Dial. 2019 Mar;32(2):187-195. doi: 10.1111/sdi.12768. Epub 2018 Nov 29.
KDIGO recently updated its clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease (CKD). The management of HCV in patients with CKD has dramatically shifted over the past 10 years with the development of direct-acting antiviral (DAA) agents and subsequent demonstration of their efficacy in CKD populations. The opportunity to cure HCV with DAA treatment has impacted all aspects of the KDIGO guideline on HCV in CKD including: (a) HCV diagnosis in CKD populations; (b) HCV treatment in CKD populations; (c) preventing HCV transmission in HD units; (d) management of HCV before and after kidney transplantation; and (e) management of HCV-associated glomerular disease. This review summarizes and discusses the major recommendations, along with the implication of the guideline on clinical practice.
改善全球肾脏病预后组织（KDIGO）最近更新了其关于慢性肾脏病（CKD）患者丙型肝炎病毒（HCV）感染的预防、诊断、评估和治疗的临床实践指南。在过去10年中，随着直接作用抗病毒（DAA）药物的开发以及随后在CKD人群中证明其疗效，CKD患者的HCV管理发生了巨大变化。使用DAA治疗治愈HCV的机会影响了KDIGO关于CKD患者HCV的指南的各个方面，包括：（a）CKD人群中的HCV诊断；（b）CKD人群中的HCV治疗；（c）在血液透析单位预防HCV传播；（d）肾移植前后的HCV管理；以及（e）HCV相关肾小球疾病的管理。本综述总结并讨论了主要建议以及该指南对临床实践的影响。
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