The reason for the association between Hepatitis C and Kidney diseases is deduced from some statistical surveys. It is very clear from studies that patients suffering from conditions such as chronic kidney disease or Kidney failure are more susceptible to hepatitis C rather than general individuals with no kidney disease. What makes the situation of patients with kidney-related issues worse is the fact that if these patients contract the Hepatitis C virus, their process of returning to normal health degrades in accordance with the type of kidney issue they are facing. For example:
If HCV is contracted by the patient:
Having Chronic Kidney Disease: Survival chances are reduced exponentially
Suffering from kidney failure: The kidney is rapidly progressing toward the end stage of acute renal failure
Who has undergone a kidney transplant: chances of graft rejection are increased
As it is clear that there is an inevitable connection between HCV and Kidney disease, we aim to make an overview of hepatitis C and Kidney disease; and also the relationship between the two in this blog.
What is hepatitis C
Hepatitis C is a viral infection that has various viral strains to cause it. If a patient is infected by hepatitis C, it is very unlikely for them to show any direct symptoms. Therefore it is very difficult for a patient to know that they are suffering from Hepatitis C. In rare cases, some patients with this virus develop symptoms such as mild fever or yellowing of the skin. Often times Hepatitis C is discovered in patients who suffer from such as liver disease or kidney disease.
- Hepatitis C is spread through
- Needle sharing
- Blood transfusion
- Physical Intercourse
Therefore, exposure to body fluids is the most common way of Hepatitis C transmission
- Diagnosis of Hepatitis C is done by
- Antibody test
- Virus RNA testing
Statistics for the relation between HCV and Kidney disease
Studies on the prevalence of Hepatitis C in patients with Kidney disease are many.
- The percentage of Hepatitis C in patients undergoing dialysis is 14 in the world
- The percentage of Hepatitis C in patients who have undergone a kidney transplant is 3- 8 worldwide
- The percentage of reduced kidney function due to Hepatitis C is 15
- With raising awareness, the number of patients on dialysis with Hepatitis C is decreasing
What are the symptoms of kidney disease in patients with Hepatitis C
As already pointed out, there are no general symptoms that indicate the presence of HCV in the body but after Hepatitis C affects the kidneys, there might be some symptoms such as:
- Hematuria
- Proteinuria
- Swelling in limbs
- Alteration in the functionality of kidneys
Some kidney diseases that may be caused by hepatitis C are:
- Nephritis
- Nephropathy
- PAN
- Cryoglobulinemia
- Membranous nephropathy
Why does 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 patients who have undergone a kidney transplant must be screened for Hepatitis C.
What are the treatments for hepatitis C in kidney disease patients
The treatment of Hepatitis C in patients with kidney disease depends upon the severity of the kidney disease. The doctors generally evaluate the severity of the impairment of kidneys by estimating the glomerular filtration rate.
- For patients with EGFR > 30, hepatitis is treated with directive antiviral agents. The reason behind using these drugs is that some of these medications are not processed by the kidneys. So they can be used safely in patients who have advanced CKD. Moreover, the other reason for using daAs is the high rates of cure, i.e., 90 percent.
- For patients with EGFR< 30, the decision to treat Hepatitis C is more individualized. The individual patient is advised by the doctors to zero in on certain factors before choosing a treatment option. These factors are:
- Chances of kidney transplant
- Type of strain of HCV
- Expectancy of life
- In some conditions of kidney disease, there is a need for immunosuppressive medications. For these patients, treatment of hepatitis is delayed by a few months.
Note: All the above treatment options are not for patients who are on dialysis.
Conclusion
As by now you might have a clearer insight into the relationship between HCV and Kidney disease, it would be apparent to you how important is it for a doctor to understand certain dimensions of the patient’s conditions. These dimensions include:
- Type of kidney disease
- The severity of the diagnosed kidney disease
- The treatment plan of the patient
- The strain of hepatitis C virus with which the patient is infected
We aim at Alfa Kidney Care to provide the best understanding of these dimensions by our most experienced nephrologists.
To know more about kidney-related issues contact: Dr. Ravi Bhadania
