Clinical and Morphological Features of Kidneys’ Damage in Patients with Chronic Hepatitis C

Abstract

The aim of the study was to evaluate frequency, types and renal manifestations in patients with chronic hepatitis C. Our research included 109 patients with chronic hepatitis C. They were examined and treated at the Department of Infectious Diseases of Bogomolets National Medical University and SI "Institute of Nephrology, NAMS of Ukraine." Renal manifestations of chronic hepatitis C were diagnosed in 12.8% of cases. Main clinical and laboratory manifestations included general weakness (was detected in 14 (100%) patients), arterial hypertension (was observed in 11 (78.6%) patients), edema (was observed in 9 (64.3%) patients), proteinuria (was observed in 14 (100%) patients) and microhematuria (was observed in 11 (78.6%) patients), nephrotic syndrome was observed in 9 (64.3%) patients. Arthralgia was observed in 3 (21.4%) patients, and purpura in 1 (7.1%) patient, eGFR reducing was in 9 (64.3%) patients. In 8 (66.7%) patients of our study elevated levels of serum cryoglobulins (from mild to high levels) were detected. According to our data long-term HCV-infection and cirrhosis were considered risk factors for the development of extrahepatic immunological diseases, including renal disease. An important role of renal biopsy in the differential diagnosis and determination of further treatment plan of patients with renal impairment in chronic hepatitis C was pointed out. We noted that kidney damage in patients with chronic hepatitis C in most of the cases were associated with the cryoglobulinemic syndrome. We performed renal biopsies in 12 patients with symptoms of chronic kidney disease and cryoglobulinemic glomerulonephritiswas detected in 7 (58.3%) patients.Other types of kidney damage detected in our study included membranoproliferative glomerulonephritis without cryoglobulinemia, membranous nephropathy, focal segmental glomerulosclerosis, mesangioproliferative glomerulonephritis.