Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease (original) (raw)

2014, Liver Transplantation

Hepatitis C virus (HCV) is associated with renal complications. We aimed to determine whether a sustained virological response (SVR) was associated with improvements in renal function (RF) in liver transplant (LT) recipients treated for HCV. Changes in RF were compared 1, 3, and 5 years after therapy as a function of the stage of chronic kidney disease (CKD) before treatment (BT). Variables associated with renal dysfunction [RD; 4-variable Modification of Diet in Renal Disease (MDRD-4) value 60 mL/minute] at the last follow-up (LFU) were evaluated for all treated LT patients with a minimum follow-up of at least 1 year since the end of treatment (EOT; n 5 175). There were 99 patients with stage 2 CKD BT (MDRD-4 value 60-89 mL/minute/1.73 m 2 ), and an improvement in RF was observed more frequently among SVR patients versus nonresponders (NRs). The median changes in the MDRD-4 values BT to 1, 3, and 5 years after treatment were 20.5, 4.5, and 9.4 mL/minute for the SVR patients and 21, 20.3, and 21.5 mL/minute for the NRs (P 5 0.61, P 5 0.06, and P 5 0.004, respectively). RD was present in 31% of the patients at the LFU at a median of 3.8 years after EOT (range 1-9 years). The follow-up did not differ between SVR patients and NRs. RD was present at the LFU in 19% of SVR patients versus 40% of NRs (P 5 0.002). In the multivariate analysis, RD at the LFU was associated with NRs [relative risk (RR) 3.8, 95% confidence interval (CI) 5 1.3-11.23, P 5 0.01], EOT MDRD-4 values (RR 5 1.022, 95% CI 5 1.001-1.04, P 5 0.04), and female sex (RR 5 5.6, 95% CI 5 1.84-17.5, P 5 0.002). In conclusion, SVR leads to improved RF in HCVinfected LT recipients with stage 2 CKD BT. Liver Transpl 20:25-34, 2014.