The effect of Hepatitis C Virus infection on cardiovascular complications in end stage kidney disease patients on regular hemodialysis

INTRODUCTION: Cardiovascular complications are the most important cause of mortality in patients with ESKD, such as coronary artery disease, left ventricular hypertrophy, heart failure and arrhythmia. Other well-known risk factors, such as diabetes mellitus, hypertension and dyslipidemia are prevalent in ESKD, yet they are not sufficient enough to explain the high prevalence of cardiovascular mortality, hence searching for other hidden risk factors to explain this high prevalence is of an utmost importance. The aim of this study was to identify the exact mechanisms connecting HCV infection, chronic liver disease, and atherogenesis. METHODS: This case control study was done on 80 patients with chronic renal failure undergoing haemodialysis at Sheikh Zayed Specialized Hospital in Giza, Egypt in 2016. The participants were divided into four groups: a control group with HCV negative by PCR (20 patients), and three HCV Positive groups according to viral load by PCR: low, moderate and high viremia. Inclusion criteria were normal serum calcium (8.5–10.5 mg/dL), phosphorus ≤5mg/dL, PTH≤250 pg/ml, Hb 10–12 g/dL, and duration of dialysis less than two years. Data were analyzed using Chi square, t-test, Mann-Whitney U test, ANOVA, and Spearman rank correlation coefficient. RESULTS: The study showed significant increase in LVM index in hemodialysis patients with high and moderate viremia compared to low viremia (p<0.001) and to control group (p<0.001). Also, significant increase in end diastolic diameter in high and moderate viremia (p<0.001), significant difference in end systolic diameter in the high viremia group (p<0.001), significant increase in the interventricular septal thickness (p<0.002) and posterior wall thickness (p<0.002) among moderate viremia were determined. CONCLUSION: HCV has a significant effect on the development of cardiovascular diseases in the general population, and in renal disease patients on the structural level.