Helsinki University Hospital, Helsinki, Finland.
Department of Medicinal Chemistry, University of Jyväskylä, Jyväskylä, Finland.
PLoS One. 2021 May 7;16(5):e0251392. doi: 10.1371/journal.pone.0251392. eCollection 2021.
Chronic kidney disease (CKD) is one of the most well-known extrahepatic manifestations caused by hepatitis C infection (HCV). CKD is typically discovered at a late stage. HCV-nephropathy may show different histopathologic patterns, as both glomerular and tubulointerstitial damage have been described. Identification of patients with early renal manifestations would be beneficial to provide treatment and avoid progression to CKD. The observational prospective single-center HCVKID study assessed the prevalence of early renal manifestations in patients with chronic HCV and compared these patients with HCV-negative healthy controls cross-sectionally. HCV-positive patients with and without renal manifestations were also compared to define biomarkers suitable for identifying early manifestations in standard clinical practice. Tubular proteinuria as judged by urine α 1-microglobulin was the most common early renal manifestation found in 11% in HCV-positive patients, followed by hematuria in 8%. Kidney filtration was statistically significantly lower among HCV-positive patients with renal manifestation according to any calculation method. There were no significant differences in duration of infection or stage of liver fibrosis between patients with or without renal manifestations. Tubular cell damage may be the earliest sign of renal dysfunction caused by HCV. Complement activation also correlates with the dysfunction, indicating of contribution to HCV-induced renal manifestations even in their early phase.
慢性肾脏病（CKD）是丙型肝炎病毒（HCV）感染引起的最著名的肝外表现之一。CKD 通常在晚期发现。HCV 相关性肾病可能表现出不同的组织病理学模式，因为肾小球和肾小管间质损伤均有描述。识别有早期肾脏表现的患者将有助于提供治疗并避免进展为 CKD。观察性前瞻性单中心 HCVKID 研究评估了慢性 HCV 患者早期肾脏表现的患病率，并将这些患者与 HCV 阴性健康对照组进行了横断面比较。还比较了有和没有肾脏表现的 HCV 阳性患者，以确定适合在标准临床实践中识别早期表现的生物标志物。尿液 α 1-微球蛋白判断的管状蛋白尿是 HCV 阳性患者中最常见的早期肾脏表现，占 11%，其次是血尿，占 8%。根据任何计算方法，有肾脏表现的 HCV 阳性患者的肾脏滤过功能均显著降低。有和没有肾脏表现的患者之间的感染持续时间或肝纤维化分期无显著差异。管状细胞损伤可能是 HCV 引起的肾功能障碍的最早迹象。补体激活也与功能障碍相关，表明即使在早期阶段，补体激活也对 HCV 引起的肾脏表现有贡献。
