Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy
The findings regarding changes in renal function in patients with hepatitis C virus (HCV) infection treated with direct-acting antivirals (DAAs) are controversial. This study attempted to identify the factors associated with the large decline in renal function following DAA treatment. This retrospec...
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MDPI AG
2023-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/3/473 |
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| author | Chun-Hsien Chen Chien-Heng Shen Kuo-Liang Wei Huang-Wei Xu Wei-Ming Chen Kao-Chi Chang Yu-Ting Huang Yung-Yu Hsieh Sheng-Nan Lu Chao-Hung Hung Te-Sheng Chang |
| author_facet | Chun-Hsien Chen Chien-Heng Shen Kuo-Liang Wei Huang-Wei Xu Wei-Ming Chen Kao-Chi Chang Yu-Ting Huang Yung-Yu Hsieh Sheng-Nan Lu Chao-Hung Hung Te-Sheng Chang |
| author_sort | Chun-Hsien Chen |
| collection | DOAJ |
| description | The findings regarding changes in renal function in patients with hepatitis C virus (HCV) infection treated with direct-acting antivirals (DAAs) are controversial. This study attempted to identify the factors associated with the large decline in renal function following DAA treatment. This retrospective cohort study included patients treated with DAAs at Chiayi and Yunlin Chang Gung Hospitals, Taiwan, from 1 January 2017 to 31 October 2020. Estimated glomerular filtration rate (eGFR) data were collected within 90 days prior to DAA therapy and 2 years after the confirmation of a sustained virologic response (SVR). We performed multiple logistic regression to evaluate the clinical or laboratory parameters associated with a large eGFR decline (≥10%). Among the enrolled 606 patients, the mean eGFR at the baseline and endpoint were 84.11 ± 24.38 and 78.88 ± 26.30 mL/min/1.73 m<sup>2</sup>, respectively (<i>p</i> < 0.001). The factors associated with a large eGFR decline 2 years after the SVR included hypertension (OR: 1.481; 95% CI: 1.010–2.173, <i>p</i> = 0.044) and a higher baseline eGFR (OR: 1.016; 95% CI: 1.007–1.024, <i>p</i> < 0.001). A higher albumin level reduced the risk of a large eGFR decline (OR: 0.546; 95% CI: 0.342–0.872, <i>p</i> = 0.011). In the patients with HCV treated with DAAs, a larger renal function decline was more commonly observed in those with hypertension, a lower (but within normal range) albumin level, and a higher baseline eGFR, while DAA treatment had no effect. The clinical significance of these findings has to be further defined. Although some risk factors associated with chronic kidney disease may be alleviated after DAA treatment, the regular control and follow-up of risk factors and renal function are still recommended in at-risk patients after HCV eradication. |
| first_indexed | 2024-03-11T09:47:37Z |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T09:47:37Z |
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| spelling | doaj.art-0ec09dafb59745aaaaea06700fc8f38d2023-11-16T16:25:13ZengMDPI AGDiagnostics2075-44182023-01-0113347310.3390/diagnostics13030473Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral TherapyChun-Hsien Chen0Chien-Heng Shen1Kuo-Liang Wei2Huang-Wei Xu3Wei-Ming Chen4Kao-Chi Chang5Yu-Ting Huang6Yung-Yu Hsieh7Sheng-Nan Lu8Chao-Hung Hung9Te-Sheng Chang10Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanThe findings regarding changes in renal function in patients with hepatitis C virus (HCV) infection treated with direct-acting antivirals (DAAs) are controversial. This study attempted to identify the factors associated with the large decline in renal function following DAA treatment. This retrospective cohort study included patients treated with DAAs at Chiayi and Yunlin Chang Gung Hospitals, Taiwan, from 1 January 2017 to 31 October 2020. Estimated glomerular filtration rate (eGFR) data were collected within 90 days prior to DAA therapy and 2 years after the confirmation of a sustained virologic response (SVR). We performed multiple logistic regression to evaluate the clinical or laboratory parameters associated with a large eGFR decline (≥10%). Among the enrolled 606 patients, the mean eGFR at the baseline and endpoint were 84.11 ± 24.38 and 78.88 ± 26.30 mL/min/1.73 m<sup>2</sup>, respectively (<i>p</i> < 0.001). The factors associated with a large eGFR decline 2 years after the SVR included hypertension (OR: 1.481; 95% CI: 1.010–2.173, <i>p</i> = 0.044) and a higher baseline eGFR (OR: 1.016; 95% CI: 1.007–1.024, <i>p</i> < 0.001). A higher albumin level reduced the risk of a large eGFR decline (OR: 0.546; 95% CI: 0.342–0.872, <i>p</i> = 0.011). In the patients with HCV treated with DAAs, a larger renal function decline was more commonly observed in those with hypertension, a lower (but within normal range) albumin level, and a higher baseline eGFR, while DAA treatment had no effect. The clinical significance of these findings has to be further defined. Although some risk factors associated with chronic kidney disease may be alleviated after DAA treatment, the regular control and follow-up of risk factors and renal function are still recommended in at-risk patients after HCV eradication.https://www.mdpi.com/2075-4418/13/3/473HCVdirect-acting antiviral therapysustained virologic responserenal function |
| spellingShingle | Chun-Hsien Chen Chien-Heng Shen Kuo-Liang Wei Huang-Wei Xu Wei-Ming Chen Kao-Chi Chang Yu-Ting Huang Yung-Yu Hsieh Sheng-Nan Lu Chao-Hung Hung Te-Sheng Chang Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy Diagnostics HCV direct-acting antiviral therapy sustained virologic response renal function |
| title | Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy |
| title_full | Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy |
| title_fullStr | Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy |
| title_full_unstemmed | Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy |
| title_short | Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy |
| title_sort | factors associated with large renal function decline in patients with chronic hepatitis c successfully treated with direct acting antiviral therapy |
| topic | HCV direct-acting antiviral therapy sustained virologic response renal function |
| url | https://www.mdpi.com/2075-4418/13/3/473 |
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