Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease. Issue 1 (21st November 2013)

• Record Type: Journal Article
• Authors: Blé, Michel; Aguilera, Victoria; Rubín, Angel; García‐Eliz, María; Vinaixa, Carmen; Prieto, Martín; Berenguer, Marina
• Is Part Of: Liver transplantation. Volume 20:Issue 1(2014:Jan.)
• Page Start: 25
• Page End: 34
• Publication Date: 2013-11-21
• Subjects: Liver -- Transplantation -- Periodicals; Liver -- Diseases -- Periodicals; Liver Transplantation -- Periodicals; Foie -- Greffe -- Périodiques; 617.5560592
• DOI: 10.1002/lt.23756
• Languages: English
• ISSNs: 1527-6465

Abstract

Abstract : Hepatitis C virus (HCV) is associated with renal complications. We aimed to determine whether a sustained virological response (SVR) was associated with improvements in renal function (RF) in liver transplant (LT) recipients treated for HCV. Changes in RF were compared 1, 3, and 5 years after therapy as a function of the stage of chronic kidney disease (CKD) before treatment (BT). Variables associated with renal dysfunction [RD; 4‐variable Modification of Diet in Renal Disease (MDRD‐4) value 60 mL/minute] at the last follow‐up (LFU) were evaluated for all treated LT patients with a minimum follow‐up of at least 1 year since the end of treatment (EOT; n = 175). There were 99 patients with stage 2 CKD BT (MDRD‐4 value 60‐89 mL/minute/1.73 m 2 ), and an improvement in RF was observed more frequently among SVR patients versus nonresponders (NRs). The median changes in the MDRD‐4 values BT to 1, 3, and 5 years after treatment were −0.5, 4.5, and 9.4 mL/minute for the SVR patients and −1, −0.3, and −1.5 mL/minute for the NRs ( P = 0.61, P = 0.06, and P = 0.004, respectively). RD was present in 31% of the patients at the LFU at a median of 3.8 years after EOT (range 1‐9 years). The follow‐up did not differ between SVR patients and NRs. RD was present at the LFU in 19% of SVR patients versus 40% of NRs ( P = 0.002). In the multivariate analysis, RD at the LFU was associated with NRs [relative risk (RR) 3.8, 95% confidence interval (CI) = 1.3‐11.23, P = 0.01], EOT MDRD‐4 values (RR = 1.022, 95% CI = 1.001‐1.04, P = 0.04), and female sex (RR = 5.6, 95% CI = 1.84‐17.5, P = 0.002). In conclusion, SVR leads to improved RF in HCV‐infected LT recipients with stage 2 CKD BT. Liver Transpl 20:25–34, 2014 . © 2013 AASLD.