Why Hepatitis C Lead To Kidney Disease
The speculations of the question of, why and how hepatitis C affects the kidneys are many. The main reason for this is the behavior of HCV in the body.
When a person is infected by HCV, the immune system is triggered to get rid of the infection. In the case of HCV, the immune system is triggered to become more active than usual leading to the deposition of complexes in the kidney. This lead to the following:
- Abnormal kidney functions
- Inflammation in the kidneys
Note: As it is seen that Hepatitis C causes the stimulation of the immune system, there is no doubt about the fact that HCV can lead to the rejection of a transplanted kidney. Therefore, it is of the utmost importance that the patients who have undergone a kidney transplant must be screened for Hepatitis C.
Can A Person Get Hepatitis C From Hemodialysis
Hemodialysis, also called dialysis, is the process of allowing a machine to clean the blood. A persons blood travels into the dialysis machine through an IV line, where the machine cleans it by removing waste products from it. It then travels back into their body through the same or another IV line.
It is possible to acquire the HCV infection from hemodialysis, although improved infection control methods have greatly reduced the possibility of this occurring. Because a person comes into contact with needles during the process, there is always the possibility of even a very small amount of cross-contamination occurring.
Additionally, there may be contamination of:
1,000 otherwise healthy kidneys from transplantation because they have come from people who were infected with hepatitis C when they died. Early research indicates that by providing follow-up antiviral therapy, it may be possible to transplant these HCV-positive kidneys into recipients who do not have hepatitis C.
A person can be eligible for a kidney transplant if they have HCV. Their medical team will consider the condition of their liver when making the decision. If the liver is not in good condition and the persons overall health is poor, their doctors may deny them a kidney transplant. If their liver is not in good condition, but their overall health is good, they may be eligible for a dual liver and kidney transplant.
Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
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Hcv And Chronic Kidney Disease
HCV may also cause mixed cryoglobulinemic syndrome, which is a systemic vasculitis that affects 2% of patients with HCV infection, with manifestations including palpable purpura, arthritis, neuropathy and glomerulonephritis. Cryoglobulinemic glomerulonephritis typically has an immune complexmediated membranoproliferative pattern of injury due to deposition of mesangial and subendothelial immune complexes, leading to glomerular hypercellularity, thickening of the glomerular basement membrane and a double-contoured appearance. Curative therapy of HCV infection leads to remission of cryoglobulinemic glomerulonephritis in the majority of patients, however, patients with rapidly progressive glomerulonephritis or nephrotic syndrome typically require up-front immunosuppression to control severe manifestations . While other glomerular diseases, including fibrillary, immunotactoid, membranous nephropathy and immunoglobulin A nephropathy, have been associated with chronic HCV infection, this may be coincidental.
On a population level, HCV infection is associated with an increased incidence of chronic kidney disease and speeds progression to end-stage renal disease . Mechanisms explaining this finding include HCVs ability to promote systemic inflammation and worsen atherosclerotic disease and insulin resistance, leading to subclinical immune-complex deposition in the kidneys of those with long-standing chronic infection.
Living With Hepatitis And Kidney Disease
Patients that have both hepatitis and kidney disease may have worse health than CKD patients without hepatitis C, especially if both diseases are not being well managed. Hepatitis C can also cause a faster progression of CKD into kidney failure. However, with the right treatment team, you can manage the symptoms and progression of both CKD and hepatitis C.
There are treatments for hepatitis C that are safe and effective for kidney patients on dialysis. Due to strictly enforced safety regulations, dialysis centers take extensive precautions to prevent the spread of all types of infection in dialysis units. Just make sure you choose healthcare providers with experience in treating and managing these conditions, and complications can be avoided.
At Durham Nephrology, we provide comprehensive care to patients in Durham and Oxford, NC with kidney disease and high blood pressure. Our team is experienced in treating and managing conditions like chronic kidney disease and complications related to hepatitis. If you have questions about recovering from a kidney transplant, call us at 919-477-3005 to talk to a staff member and make an appointment.
When you visit our offices, you can be confident that we are taking the necessary precautions to protect the health of our patients as well as our staff. We are following all guidelines for sanitization, social distancing, and face coverings.
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Impact On The Integumentary System
Hepatitis C is associated with a wide variety of skin problems. Some common conditions include easy bruising, loss of skin pigment, rashes, and itching.
Bilirubin is an important substance that comes from the breakdown of hemoglobin. When the liver cant do its job, bilirubin can build up and cause jaundice, or the yellowing of your skin and the whites of your eyes.
Poor liver function can also lead to poor nutrition. This leads to inadequate growth of hair and nails as well.
Skin conditions that may occur include:
- porphyria cutanea tarda, which is a kind of photosensitivity leading to skin blistering
- lichen planus, which are purple, itchy papules than can appear on the skin and in the mouth
- leukocytic vasculitis, which is inflammation of the small blood vessels
The endocrine system regulates hormones. As part of the endocrine system, the thyroid gland delivers hormones into the bloodstream.
Sometimes HCV can cause the immune system to mistakenly attack or damage thyroid tissue. This
Liver Disease Rash: A Symptom And A Sign
What is a liver disease rash?Dermatologists find that our skin often shows what is happening inside of the body. A liver disease rash could indicate a further health problem. An example of where this effects your liver would be jaundice, where the skin and the whites of the eyes become yellow. Although yellowing skin is not the only skin change that indicates liver disease, darkening of the skin and bronzing of the skin can point to liver disease or failure and rashes can point to a number of liver health problems.
Whats in this article
A liver disease rash and hepatitis C
Skin rashes may be a sign of hepatitis C, and should not be ignored. Rashes that appear on your skin as a result of hepatitis c show that your body is busy trying to fight the infection on its own. This rash is called urticaria and is the most common rash for those suffering from acute hepatitis c virus. This is a short-term infection, according to the National Digestive Diseases Information Clearinghouse, acute HCV typically lasts for six months or less. Urticaria can also cause the skin to swell, rashes on your face and often comes in rounds that can last for several hours. Urticaria can also develop as a result of certain allergic reactions.
Signs & symptoms
If a rash is due to liver damage skin symptoms may include:
Additional symptoms may include stomach swelling and bleeding that does not stop.
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Side Effects Of Antiviral Therapy
Treatment with IFN and ribavirin is associated with frequent and sometimes serious side effects. Among the latter are autoimmune diseases , significant hemolytic anemia and severe depression. In a recent meta-analysis of eleven clinical studies published by Fabrizi et al, the summary estimate for dropout rate was 0.18 , with a large heterogeneity across studies, mainly due to anemia and infections .
Except from hemolytic anemia, side effects are mainly related to IFN. The majority of the patients receiving IFN presents with a flu-like syndrome, characterized by diffuse myalgia, headache, fatigue and fever. Generally, these symptoms are self-limited and managed by common analgesics. Depression can be induced by IFN in 20% to 30% of the cases, usually after three months of treatment. Being mild to moderate in intensity, IFN-induced depression can generally be handled with conservative measures, by non-psychiatrist professionals. However, if severe depression develops, HCV treatment must be stopped and the patient should be immediately referred to a psychiatrist. IFN-induced cytopenias , are relatively common, typically dose-dependent and rarely associated with clinically significant complications, even in CKD patients. IFN dose reductions and the use of growth factors usually allow the continuation of therapy.
How Does Hepatitis B Affect The Kidneys
In a large study, individuals who tested positive for hepatitis B virus at a health screening visit had an 11% higher risk of CKD. Hepatitis B virus infection is associated with an increased risk of chronic kidney disease , according to a new study.
Does hepatitis A cause kidney failure?
Hepatitis A, B and C viruses are major causes of viral hepatitis in human. These infectious agents not only damage liver parenchyma but can also affect renal parenchyma. Hepatitis A virus could produce acute renal failure in a similar fashion to hepatorenal syndrome.
Can hepatitis affect the bladder?
This can lead to stress on those organs, as well as some lack of functioning. One of the symptoms of hepatitis C is dark colored urine. As that urine passes through the kidneys, ureters, and bladder, each can be impacted by the incorrect balance of fluids and nutrients that lead to the darkened color of the urine.
Does hepatitis cause protein in urine?
One could have hepatitis B virus infection and have blood protein in the urine for an entirely different reason . Confirmation of final diagnosis and its cause has a huge impact on treatment plan as well.
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Interaction Of Hepatitis C Infection And Renal Disease
Several studies have shown that patients on chronic hemodialysis have an increased overall mortality risk if they have chronic hepatitis C infection . There are also some data showing that chronic hepatitis C may be a risk factor for developing renal cell carcinoma. Chronic hepatitis C infection has also been associated with an accelerated course of renal disease, including in persons with HIV coinfection. Extrahepatic manifestations related to HCV, including immune complex-related renal disease, can require urgent HCV treatment to resolve or prevent further organ damage.
Safety And Effectiveness Of Direct
Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Myeong Jun Song, M.D
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What Does Hepatitis B Primarily Affect
Hepatitis B and C are common blood-borne viral infections that primarily affect the liver.
Does hepatitis affect the liver?
What is hepatitis and how does it affect my liver? The medical term hepatitis means inflammation of the liver. Chronic inflammation of the liver may result in liver damage or failure if left untreated.
Can Hep cause kidney disease?
HCV infection is a recognized cause of progression to kidney failure, and is associated with reduced survival in the CKD population. A study by Molnar et al found that HCV infection is associated with a higher mortality risk, incidence of decreased kidney function, and progressive loss of kidney function.
Does hepatitis cause yellow urine?
Since hepatitis A is a virus, it can pass from person to person from eating or drinking contaminated food or coming into contact with contaminated materials containing the virus. Symptoms of hepatitis A include stomach pain, diarrhea, dark yellow urine, jaundice, and more.
Theres Reason For Hope With Hepatitis C
Unfortunately, even when people are diagnosed with hepatitis C, many dont do anything about it. According to the CDC, of people with hepatitis C who have private health insurance, only about a third receive medical care for their condition.
Yet Singh says hes seeing more people with hepatitis C than ever before, as people are finding out that new treatment options often work well. New treatments for hepatitis C have been revolutionary, he says. Over 95 percent of patients can be cured with three months of treatment.
Newer antiviral drugs can clear the virus even if youve had no luck with earlier medications. They also generally take less time to start working, cause fewer side effects, and can treat and even eliminate illnesses caused by hepatitis C.
The CDC recommends that all Americans over age 18 get screened at least once. Pregnant women should be tested during each pregnancy. People who inject drugs, share needles, or have received maintenance hemodialysis are also at risk. If you are in one of these higher-risk groups, you should be tested routinely. Talk to your primary care doctor if you havent yet been screened yet or are at increased risk.
If you do test positive and get treated, keep in mind that damage from cirrhosis usually cant be reversed, Singh says. Following treatment, youll be monitored closely for liver cancer and other health problems.
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Chronic Kidney Disease Linked To Hepatitis B
Hepatitis B virus infection is associated with an increased risk of chronic kidney disease , according to a new study.
The study included 299,913 adults free of CKD at baseline who underwent health screening examinations from January 2002 to December 2016 in South Korea. In a fully adjusted model, individuals who tested positive for hepatitis B surface antigen had a significant 11% increased risk of incident CKD compared with those who tested negative, Yun Soo Hong, MD, of the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues reported in BMC Nephrology. The investigators defined incident CKD as development of an estimated glomerular filtration rate below 60 mL/min/1.73 m2 and/or proteinuria.
HBsAG positivity was associated with a significant 23% increased risk of incident proteinuria and a non-significant 11% decreased risk of an eGFR below 60 mL/min/1.73 m2.
The investigators adjusted for age, sex, screening center, baseline eGFR, smoking status, alcohol consumption, education level, physical activity level, and the presence of hypertension, diabetes, and fatty liver disease.
Of the 299,913 study participants, 11,209 tested positive for HBsAG. These patients were significantly older than those who tested negative and more likely to be male . The HBsAG positive group also had a significantly higher proportion of current smokers .
Antiviral Therapy In Kidney Transplant Recipients
Posttransplant administration of IFN-α to HCV-positive recipients with liver disease and stable renal function improved liver function in 50% of patients, and led to negative HCV RNA in 25% of cases .
A meta-analysis of 12 trials of IFN-based therapy in 102 kidney transplant patients showed that SVR response was very heterogeneous, ranging from 0% to 50%, and the rate of drop-out was remarkably high . Even in the kidney transplant settings, the SVR response to antiviral therapy depends upon the HCV genotype, HCV1 being the more resistant . The beneficial effect on liver disease can, however, be associated with 15% to 60% increased risk of acute cellular or vascular rejection, and the rate of graft loss may rise up to 20% . Graft rejection is frequently irreversible and steroid-resistant . Induction of cell surface expression of HLA alloantigens, intracellular cytokine gene expression, as well as increase in antibody production by B cells are possible mechanisms through which IFN may trigger acute graft rejection .
However, after discontinuation of the therapy a rebound of the HCV viral load to pretreatment levels was documented . It has therefore been recommended to avoid IFN in HCV-positive renal transplant patients because of the potential to precipitate graft rejection or the relapse of infection upon drug withdrawal.
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Demographic And Clinical Characteristics Of The Study Participants
A total of 2,435 subjects completed the survey and examination in this study. The mean age was 50.3±10.3 years, and 52.5% of patients were women. The study subjects were divided into four groups based on the types of viral hepatitis, according to the following distribution: HCV infection , HBV infection , HBV/HCV co-infection , and uninfected controls . The demographic and clinical characteristics of the study subjects in the four groups are summarized in Table . The HCV infection group had an older mean age , higher rates of diabetes mellitus and CKD , and higher levels of hemoglobin , alanine aminotransferase , total bilirubin , serum urea nitrogen , and serum creatinine compared to the HBV group, which had a mean age of 46.0±10.2 years and CKD prevalence of 19.7%. Notably, the uninfected control group had higher levels of platelets , albumin , triglycerides , and cholesterol compared with the HCV infection, HBV infection, and HBV/HCV co-infection groups.
Table 1 Baseline characteristics of chronic hepatitis patients and controls.
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Is There A Link Between Hepatitis And Kidney Disease
World Hepatitis Day is coming up on July 28th. The aim of this event is to raise awareness about the disease because hundreds of millions of people worldwide are affected by viral hepatitis and many of them are undiagnosed. To help spread awareness among kidney patients, we are taking the opportunity to explore how hepatitis and kidney disease are linked.
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