Association of Reduced Renal Function with Hepatitis B... : Clinical Journal of the American Society of Nephrology (original) (raw)

Original Articles

Association of Reduced Renal Function with Hepatitis B Virus Infection and Elevated Alanine Aminotransferase

Cai, Jianfang*,†; Fan, Xiaohong*; Mou, Lijun*; Gao, Bixia*; Liu, Xuejiao*; Li, Jinhong*; Liu, Lili*; Wang, Haiyun*; Guo, Zengyu‡; Liu, Xiaoqing†,§; Li, Hang*; Li, Xuemei*; Li, Xuewang*

Departments of *Nephrology and

§Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China;

†Clinical Epidemiology Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and

‡Department of Nephrology, Pinggu Hospital of Beijing, Beijing, China

Correspondence: Dr. Xuewang Li, Department of Nephrology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. Email: [email protected]

Received July 21, 2011

Accepted July 8, 2012

Online date: October 05, 2012

Abstract

Background and objectives

Clinically, hepatitis B virus (HBV) infection is observed to be associated with nephropathy. However, previous population-based studies failed to show an association between HBV infection and CKD. Therefore, this cross-sectional study was designed to further explore this association.

Design, setting, participants, & measurements

A representative sample of 6854 Chinese adults aged 30–75 years was tested for levels of serum hepatitis B surface antigen, alanine aminotransferase (ALT), creatinine, urinary albumin/creatinine ratio, and potential CKD risk factors.

Results

Neither HBV infection nor elevated ALT (ALT+; ≥ sex-specific 90th percentile of ALT levels of noninfected persons) was significantly associated with reduced estimated GFR (eGFR < 60 ml/min per 1.73 m2). Compared with noninfected persons, HBV-infected persons with ALT+, but not those with ALT− (_P_=0.26), were more likely to have reduced eGFR (odds ratio, 4.07; 95% confidence interval, 1.18–14.0; _P_=0.03). Further analysis with a general linear model revealed a significant difference in eGFR (mean ± SEM) between HBV-infected and noninfected persons (87.8±0.8 versus 90.2±0.4 ml/min per 1.73 m2; _P_=0.002). This difference was mainly derived from that between HBV-infected persons with ALT+ and noninfected persons, with an average difference in eGFR of −4.5 (95% confidence interval, −0.9 to −8.1; _P_=0.01). HBV infection and ALT+, alone or in combination, were not significantly associated with albuminuria or CKD.

Conclusions

HBV infection with elevated ALT, rather than HBV infection alone, was associated with reduced renal function.