Association of reduced renal function with different phase of chronic hepatitis B virus infection

Authors

  • Guangdong Tong Division of Hepatology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine
  • Weichao Zhong
  • Deti Peng
  • Xiaoyan Jiang
  • Tianran Zhou
  • Furong Huang
  • Chengman Tian
  • Chunshan Wei
  • Yufeng Xing
  • Jing Yuan
  • Jian Yang
  • Jin Wu
  • Jiong Yang
  • Chenghui Huang
  • Zhijun Qu

DOI:

https://doi.org/10.54844/gmiw.2022.0181

Abstract

Background: The association between chronic hepatitis B virus (HBV) infection and the development of chronic kidney disease (CKD) remains controversial, and whether the cause is related to the different phases of chronic HBV infection remains unclear. Methods: A large cross-sectional study was performed to show the prevalence of reduced renal function during chronic HBV infection in adults from 7 multi-centers of Shenzhen City in China. Estimated glomerular filtration rate (eGFR) was used to evaluate the effect of HBV infection on the risk of renal impairment. Results: 33.04% HBsAg (+) patients had eGFR < 90, while patients without HBV exposure, 32.73% had eGFR < 90, showing no significant difference. There was no significant difference between those with elevated and normal alanine aminotransferase (ALT) in chronic hepatitis B (CHB) groups. Moreover, according to stratified statistics of different phases of the disease, liver cirrhosis, especially decompensated liver cirrhosis, hepatocellular carcinoma (HCC) showed a significant decrease in renal function compared with CBH (P = 0). Multivariate logistic regression analysis showed that liver disease different phases independently associated with reduced renal function. Conclusion: During the early CHB phase of chronic HBV infection (either elevated ALT or normal) did not increase the risk of renal dysfunction compares no exposure to HBV. However, when CHB progress to end-stage liver disease were associated with reduced kidney function. Additionally, Hoek formula should be recommended for patients with end-stage liver disease.

References

Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet. 2012;379(9818):815–822. [PMID: 22386035 DOI:10.1016/S0140-6736(12)60033-6]

Wright J, Hutchison A. Cardiovascular disease in patients with chronic kidney disease. Vasc Health Risk Manag. 2009; 5:713–722. [PMID: 19756163 DOI:10.2147/vhrm.s6206]

Foley RN. Temporal trends in the burden of chronic kidney disease in the United States. Curr Opin Nephrol Hypertens 2010;19:273–277.

Stengel B, Billon S, Van Dijk PC, et al. Trends in the incidence of renal replacement therapy for end-stage renal disease in Europe, 1990-1999. Nephrol Dial Transplant. 2003;18(9):1824-1833. [PMID: 12937231 DOI:10.1093/ndt/gfg233]

Chen N, Wang W, Huang Y, et al. Community-based study on CKD subjects and the associated risk factors. Nephrol Dial Transplant. 2009;24(7):2117–2123. [PMID: 19193736 DOI:10.1093/ndt/gfn767]

Li W. The hepatitis B virus receptor. Annu Rev Cell Dev Biol. 2015;31:125–147. [PMID:26436705 DOI:10.1146/annurev-cellbio-100814-125241]

Liang X, Bi S, Yang W, et al. Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination. Vaccine. 2009;27(47):6550–6557. [PMID:19729084 DOI:10.1016/j.vaccine.2009.08.048]

Ganem D, Prince AM. Hepatitis B virus infection-natural history and clinical consequences. N Engl J Med. 2004;350(11):1118–1129. [PMID:15014185 DOI:10.1056/NEJMra031087]

Johnson RJ, Couser WG. Hepatitis B infection and renal disease: clinical, immunopathogenetic and therapeutic considerations. Kidney Int. 1990;37(2):663–676. [PMID:1968522 DOI:10.1038/ki.1990.32]

Takekoshi Y, Tochimaru H, Nagata Y, Itami N. Immunopathogenetic mechanisms of hepatitis B virus-related glomerulopathy. Kidney Int Suppl. 1991;35:34–39. [PMID:1837572]

Lai KN, Li PK, Lui SF, et al. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med. 1991;324(21):1457–1463. [PMID:2023605 DOI:10.1056/NEJM199105233242103]

Lai KN, Ho RT, Tam JS, Lai FM. Detection of hepatitis B virus DNA and RNA in kidneys of HBV related glomerulonephritis. Kidney Int. 1996;50(6):1965–1977. [PMID:8943480 DOI:10.1038/ki.1996.519]

Fabrizi F, Donato FM, Messa P. Association between hepatitis B virus and chronic kidney disease: a systematic review and meta-analysis. Ann Hepatol. 2017;16(1):21–47. [PMID:28051791 DOI:10.5604/16652681.1226813]

Lin MY, Chiu YW, Lee CH, et al. Factors associated with CKD in the elderly and nonelderly population. Clin J Am Soc Nephrol. 2013;8(1):33–40. [PMID:23085726 DOI:10.2215/CJN.05600612]

Amet S, Bronowicki JP, Thabut D, et al. Prevalence of renal abnormalities in chronic HBV infection: the HARPE study. Liver Int. 2015;35(1):148–155. [PMID:24502506 DOI:10.1111/liv.12480]

Chen YC, Su YC, Li CY, Hung SK. 13-year nationwide cohort study of chronic kidney disease risk among treatment-naive patients with chronic hepatitis B in Taiwan. BMC Nephrol. 2015;16:110. [PMID:26199000 doi:10.1186/s12882-015-0106-5]

Zeng Q, Gong Y, Dong S, Xiang H, Wu Q. Association between exposure to hepatitis B virus and chronic kidney disease in China. J Int Med Res. 2014;42(5):1178–1184. [PMID:25239876 DOI:10.1177/0300060514541828]

Ishizaka N, Ishizaka Y, Seki G, Nagai R, Yamakado M, Koike K. Association between hepatitis B/C viral infection, chronic kidney disease and insulin resistance in individuals undergoing general health screening. Hepatol Res. 2008;38(8):775–783. [PMID:18371161 DOI:10.1111/j.1872-034X.2008.00334.x]

Lee JJ, Lin MY, Yang YH, Lu SN, Chen HC, Hwang SJ. Association of hepatitis C and B virus infection with CKD in an endemic area in Taiwan: a cross-sectional study. Am J Kidney Dis. 2010;56(1):23–31. [PMID:20400217 DOI:10.1053/j.ajkd.2010.01.015]

Cai QC, Zhao SQ, Shi TD, Ren H. Relationship between hepatitis B virus infection and chronic kidney disease in Asian populations: a meta-analysis. Ren Fail. 2016;38(10):1581–1588. [PMID:27756165 DOI:10.1080/0886022X.2016.1229548]

Cai J, Fan X, Mou L, et al. Association of reduced renal function with hepatitis B virus infection and elevated alanine aminotransferase. Clin J Am Soc Nephrol. 2012;7:1561–1566. [PMID:22859746 DOI:10.2215/CJN.07410711]

Nair S, Verma S, Thuluvath PJ. Pretransplant renal function predicts survival in patients undergoing orthotopic liver transplantation. Hepatology. 2002;35:1179–1185. [PMID:11981768 DOI:10.1053/jhep.2002.33160]

Amarapurkar DN, Dhawan P, Kalro RH. Role of routine estimation of creatinine clearance in patients with liver cirrhosis. Indian J Gastroenterol. 1994;13(3):79–82. [PMID:8076985]

Kim SU, Han KH, Nam CM, et al. Natural history of hepatitis B virus-related cirrhotic patients hospitalized to control ascites. J Gastroenterol Hepatol. 2008;23(11):1722–1727. [PMID:18717757 DOI:10.1111/j.1440-1746.2008.05510.x]

Brown RS, Lombardero M, Lake JR. Outcome of patients with renal insufficiency undergoing liver or liver-kidney transplantation. Transplantation. 1996;62(12):1788-1793. [PMID:8990364 DOI:10.1097/00007890-199612270-00018]

Zuo L, Sun F, Wang X, et al. [Clinical analysis of 298 cases of liver cirrhosis and renal dysfunction]. Zhonghua Gan Zang Bing Za Zhi. 2014;22(7):504–508. [PMID:25203801 DOI:10.3760/cma.j.issn.1007-3418.2014.07.006]

Kim YJ, Cho HC, Sinn DH, et al. Frequency and risk factors of renal impairment during long-term adefovir dipivoxil treatment in chronic hepatitis B patients. J Gastroenterol Hepatol. 2012;27(2):306–312. [PMID:21777281 DOI:10.1111/j.1440-1746.2011.06852.x]

Mederacke I, Yurdaydin C, Grosshennig A, et al. Renal function during treatment with adefovir plus peginterferon alfa-2a vs either drug alone in hepatitis B/D co-infection. J Viral Hepat. 2012;19:387–395. [PMID:22571900 DOI:10.1111/j.1365-2893.2011.01560.x]

Lampertico P, Vigano M, Yurdaydin C, et al. Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Field Practice: A Multicenter European Cohort Study of 737 Patients with Chronic Hepatitis B. Hepatology. 2010;52:503–503.

Gish RG, Clark MD, Kane SD, Shaw RE, Mangahas MF, Baqai S. Similar risk of renal events among patients treated with tenofovir or entecavir for chronic hepatitis B. Clin Gastroenterol Hepatol. 2012;10(8):941–946. [PMID:22507876 DOI:10.1016/j.cgh.2012.04.008]

Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. [PMID:1244564 DOI:10.1159/000180580]

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130(6):461–470. [PMID:10075613 DOI:10.7326/0003-4819-130-6-199903160-00002]

Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–612. [PMID:19414839 DOI:10.7326/0003-4819-150-9-200905050-00006]

Mauss S, Berger F, Filmann N, et al. Effect of HBV polymerase inhibitors on renal function in patients with chronic hepatitis B. J Hepatol. 2011;55(6):1235–1240. [PMID:21703180 DOI:10.1016/j.jhep.2011.03.030]

Kim SE, Jang ES, Ki M, et al. Chronic Hepatitis B Infection Is Significantly Associated with Chronic Kidney Disease: a Population-based, Matched Case-control Study. J Korean Med Sci. 2018;33(42):264. [PMID:30310365 DOI:10.3346/jkms.2018.33.e264]

McMahon BJ. The natural history of chronic hepatitis B virus infection. Hepatology. 2009;49:45–55. [PMID:19399792 DOI:10.1002/hep.22898]

Gluhovschi C, Velciov S, Buzas R, et al. Is There any Difference Between the Glomerular Filtration Rate of Patients With Chronic Hepatitis B and C and Patients With Cirrhosis? Hepat Mon. 2013;13(4):6789. [PMID:23805157 DOI:10.5812/hepatmon.6789]

Caregaro L, Menon F, Angeli P, et al. Limitations of serum creatinine level and creatinine clearance as filtration markers in cirrhosis. Arch Intern Med. 1994;154(2):201–205. [PMID: 8285815]

Juutilainen A, Kastarinen H, Antikainen R, et al. Comparison of the MDRD Study and the CKD-EPI Study equations in evaluating trends of estimated kidney function at population level: findings from the National FINRISK Study. Nephrol Dial Transplant. 2012;27(8):3210–3217. [PMID:22492828 DOI:10.1093/ndt/gfs047]

Woitas RP, Stoffel-Wagner B, Flommersfeld S, et al. Correlation of serum concentrations of cystatin C and creatinine to inulin clearance in liver cirrhosis. Clin Chem. 2000;46:712–715. [PMID:10794756 DOI:10.1093/clinchem/46.5.712]

Axelsen RA, Crawford DH, Endre ZH, et al. Renal glomerular lesions in unselected patients with cirrhosis undergoing orthotopic liver transplantation. Pathology. 1995;27(3):237–246. [PMID:8532390 DOI:10.1080/00313029500169053]

Pöge U, Gerhardt T, Stoffel-Wagner B, et al. Cystatin C-based calculation of glomerular filtration rate in kidney transplant recipients. Kidney Int. 2006;70(1):204–210. [PMID:16723983 DOI:10.1038/sj.ki.5001502]

Gerhardt T, Pöge U, Stoffel-Wagner B, et al. Estimation of glomerular filtration rates after orthotopic liver transplantation: Evaluation of cystatin C-based equations. Liver Transpl. 2006;12(11):1667–1672. [PMID:17031831 DOI:10.1002/lt.20881]

Karetnikova VN, Osokina AV, Evseeva MV, et al. Renal function estimation formulas in predicting long-term cardiovascular outcomes in patients with myocardial infarction concurrent with diabetes mellitus. Ter Arkh. 2016;88(4):35–40. [PMID:27070161 DOI:10.17116/terarkh201688435-40]

Downloads

Published

2022-06-16

How to Cite

1.
Tong G, Zhong W, Peng D, Jiang X, Zhou T, Huang F, Tian C, Wei C, Xing Y, Yuan J, Yang J, Wu J, Yang J, Huang C, Qu Z. Association of reduced renal function with different phase of chronic hepatitis B virus infection. Gut Microb Integr Wellness. 2022;1. doi:10.54844/gmiw.2022.0181

Issue

Section

Original Articles