Incidence and Progression of Chronic Kidney Disease After Hepatitis C Seroconversion: Results from ERCHIVES

Adult Liver Cirrhosis Male 0301 basic medicine 0303 health sciences Incidence Age Factors Comorbidity Middle Aged Hepatitis C 3. Good health Cohort Studies 03 medical and health sciences Risk Factors Seroconversion Hypertension Diabetes Mellitus Disease Progression Humans RNA, Viral Female Renal Insufficiency, Chronic Proportional Hazards Models Retrospective Studies
DOI: 10.1007/s10620-015-3918-z Publication Date: 2015-11-02T01:47:15Z
ABSTRACT
We aimed to assess the incidence and progression of chronic kidney disease (CKD) following hepatitis C virus (HCV) seroconversion.This retrospective cohort study included Veterans with a confirmed HCV seroconversion between 2001 and 2014 and Veterans with negative HCV testing over the same time period. The outcomes included development of advanced CKD (eGFR < 60 mL/min/1.73 m(2) on two separate occasions at least 90 days apart, plus a ≥ 10 mL/min/1.73 m(2) decline from baseline) and progressive CKD (decline in eGFR of ≥ 30 mL/min/1.73 m(2) from baseline). Multivariable Cox proportional hazards models were used to evaluate the association between HCV and incident advanced and progressive CKD.The final cohort consisted of 71,528 Veterans, including 2589 with recently seroconverted HCV. Over a mean follow-up of 6 years, 36% of patients with and 31% without HCV developed advanced CKD (p < 0.001), and 35% of patients with vs. 26% without HCV developed progressive CKD (p < 0.001). After controlling for traditional risk factors, recently seroconverted HCV+ patients were significantly less likely to develop advanced CKD (HR 0.86; 95% CI 0.79, 0.92), and HCV status was not significantly associated with progressive CKD (HR 0.93; 95% CI 0.86, 1.00). Factors associated with developing advanced and progressive CKD included older age, female sex, diabetes, hypertension, development of cirrhosis, and substance abuse.In this cohort of newly infected US Veterans, HCV infection was associated with decreased incidence of advanced and unchanged risk of progressive CKD, suggesting a larger role for traditional risk factors in the development of CKD after HCV seroconversion.
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