Serial changes of renal function after directly acting antivirals treatment for chronic hepatitis C: A 1-year follow-up study after treatment

BACKGROUND: Our preliminary data showed a slight decrease of estimated glomerular filtration rate (eGFR) after direct-acting antivirals (DAAs) treatment in chronic hepatitis C (CHC). However, long-term outcome of renal evolution after DAAs has not been well documented. AIM: To assess the renal function under DAAs treatment in CHC patients of an Asian population at 6 months and 1 year after complete treatment. METHODS: A cohort of 1536 CHC patients who received therapies with DAAs were analyzed. Serial eGFR levels at 24 weeks after treatment (SVR(24)) and 48 weeks after treatment (SVR(48)) were evaluated. We compared eGFR at baseline, SVR(12), SVR(24) and SVR(48), and defined renal function deterioration as decrease of eGFR >25% from baseline to SVR(24) and SVR(48). RESULTS: Overall, there was decline of eGFR from SVR(12) to SVR(48) in all patients (84.30 ± 27.00 -> 73.20 ± 28.67 mL/min/1.73m(2), p<0.001). This trend of decline was similar in all groups. Multivariate analysis for deterioration in renal function from baseline to SVR(24) showed liver transplantation, hypertension and baseline eGFR < 60 mL/min/1.73m(2) were independent risk factors. Multivariate analysis for persistent deterioration in renal function from baseline to SVR(48) showed liver transplantation, baseline eGFR < 60 mL/min/1.73m(2) and DCV/ASV use were independent predictive factors. CONCLUSIONS: There is a trend of decline in eGFR at 1-year after DAAs treatment regardless of baseline renal function or DAAs. Liver transplantation and baseline eGFR < 60 mL/min/1.73m(2) were independent predictive factors of persistent deterioration in renal function from baseline to SVR(48). Close monitoring renal function in these patients was suggested.