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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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Autores principales: Chen, Chun-Hsien, Shen, Chien-Heng, Wei, Kuo-Liang, Xu, Huang-Wei, Chen, Wei-Ming, Chang, Kao-Chi, Huang, Yu-Ting, Hsieh, Yung-Yu, Lu, Sheng-Nan, Hung, Chao-Hung, Chang, Te-Sheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914858/
https://www.ncbi.nlm.nih.gov/pubmed/36766578
http://dx.doi.org/10.3390/diagnostics13030473
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author Chen, Chun-Hsien
Shen, Chien-Heng
Wei, Kuo-Liang
Xu, Huang-Wei
Chen, Wei-Ming
Chang, Kao-Chi
Huang, Yu-Ting
Hsieh, Yung-Yu
Lu, Sheng-Nan
Hung, Chao-Hung
Chang, Te-Sheng
author_facet Chen, Chun-Hsien
Shen, Chien-Heng
Wei, Kuo-Liang
Xu, Huang-Wei
Chen, Wei-Ming
Chang, Kao-Chi
Huang, Yu-Ting
Hsieh, Yung-Yu
Lu, Sheng-Nan
Hung, Chao-Hung
Chang, Te-Sheng
author_sort Chen, Chun-Hsien
collection PubMed
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(2), respectively (p < 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, p = 0.044) and a higher baseline eGFR (OR: 1.016; 95% CI: 1.007–1.024, p < 0.001). A higher albumin level reduced the risk of a large eGFR decline (OR: 0.546; 95% CI: 0.342–0.872, p = 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.
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spelling pubmed-99148582023-02-11 Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy Chen, Chun-Hsien Shen, Chien-Heng Wei, Kuo-Liang Xu, Huang-Wei Chen, Wei-Ming Chang, Kao-Chi Huang, Yu-Ting Hsieh, Yung-Yu Lu, Sheng-Nan Hung, Chao-Hung Chang, Te-Sheng Diagnostics (Basel) Article 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(2), respectively (p < 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, p = 0.044) and a higher baseline eGFR (OR: 1.016; 95% CI: 1.007–1.024, p < 0.001). A higher albumin level reduced the risk of a large eGFR decline (OR: 0.546; 95% CI: 0.342–0.872, p = 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. MDPI 2023-01-27 /pmc/articles/PMC9914858/ /pubmed/36766578 http://dx.doi.org/10.3390/diagnostics13030473 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Chun-Hsien
Shen, Chien-Heng
Wei, Kuo-Liang
Xu, Huang-Wei
Chen, Wei-Ming
Chang, Kao-Chi
Huang, Yu-Ting
Hsieh, Yung-Yu
Lu, Sheng-Nan
Hung, Chao-Hung
Chang, Te-Sheng
Factors Associated with Large Renal Function Decline in Patients with Chronic Hepatitis C Successfully Treated with Direct-Acting Antiviral Therapy
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914858/
https://www.ncbi.nlm.nih.gov/pubmed/36766578
http://dx.doi.org/10.3390/diagnostics13030473
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