Microalbuminuria e insuficiencia renal en la infección crónica por el virus de la hepatitis C / Microalbuminuria and renal insufficiency in chronic hepatitis C virus infection

Introducción La infección crónica por el virus de la hepatitis C (VHC) se ha asociado a enfermedad glomerular, que se manifiesta mediante proteinuria con o sin disfunción renal. Método Estudio observacional analítico transversal con 120 pacientes infectados por el VHC y 145 controles VHC-negativos para determinar la prevalencia de daño renal asociada al VHC y su relación con factores de riesgo. Se recogieron datos de la historia clínica y anamnesis y se realizaron al menos 3 análisis de sangre y orina en un año. La insuficiencia renal se definió por un filtrado glomerular estimado inferior a 60ml/min/1,73 m2 y/o una microalbuminuria superior a 20mg/l o un índice microalbuminuria/creatinina mayor de 30 μg/mg. Resultados La prevalencia de microalbuminuria e insuficiencia renal se estimó en el 19,3 y 11,7% en los VHC-positivos vs el 10,5 y 0,7% en los VHC-negativos (p = 0,04), respectivamente. El 26,1% de los pacientes VHC-positivos tenía algún signos de daño renal vs el 11,8% de los VHC-negativos (p = 0,003). La infección por el VHC se asoció de forma independiente y significativa con la probabilidad de deterioro de la función renal. La prevalencia de microalbuminuria e insuficiencia renal se incrementó progresivamente con el aumento de edad. Conclusión Los pacientes VHC-positivos presentan una alta prevalencia de microalbuminuria e insuficiencia renal en comparación con sujetos VHC-negativos. El riesgo de insuficiencia renal asociado al VHC es independiente en presencia de otros factores predisponentes como hipertensión arterial y diabetes (AU)

Introduction Chronic hepatitis C virus (HCV) infection is associated with glomerular disease, which is manifested by proteinuria with or without renal dysfunction. Method To determine the prevalence of HCV-associated renal injury and associated risk factors, we performed an observational, analytic, cross-sectional study of 120 HCV-positive patients and 145 HCV-negative controls. Data were gathered from medical records and history-taking and at least three blood and urine analyses were performed over a 1-year period. Renal insufficiency was defined as an estimated glomerular filtration rate of less than 60ml/min/1.73 m2 and/or microalbuminuria of more than 20mg/l or a microalbumin/creatinine ratio higher than 30 mcg/mg. Results The prevalence of microalbuminuria and renal insufficiency was 19.3% and 11.7% in HCV-positive patients versus 10.5% and 0.7% in HCV-negative controls (p 0.04), respectively. A total of 26.1% of HCV-positive patients had signs of renal injury compared with 11.8% of HCV-negative controls (p 0.003). HCV infection was independently and significantly associated with the probability of worsening of renal function. The prevalence of microalbuminuria and renal insufficiency progressively increased with greater age. Conclusion HCV-positive patients show a high prevalence of microalbuminuria and renal insufficiency compared with HCV-negative individuals. The risk of HCV-associated renal insufficiency is independent of the presence of other predisposing factors such hypertension and diabetes (AU)

[Microalbuminuria and renal insufficiency in chronic hepatitis C virus infection]. / Microalbuminuria e insuficiencia renal en la infección crónica por el virus de la hepatitis C.

INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with glomerular disease, which is manifested by proteinuria with or without renal dysfunction. METHOD: To determine the prevalence of HCV-associated renal injury and associated risk factors, we performed an observational, analytic, cross-sectional study of 120 HCV-positive patients and 145 HCV-negative controls. Data were gathered from medical records and history-taking and at least three blood and urine analyses were performed over a 1-year period. Renal insufficiency was defined as an estimated glomerular filtration rate of less than 60ml/min/1.73 m2 and/or microalbuminuria of more than 20mg/l or a microalbumin/creatinine ratio higher than 30 mcg/mg. RESULTS: The prevalence of microalbuminuria and renal insufficiency was 19.3% and 11.7% in HCV-positive patients versus 10.5% and 0.7% in HCV-negative controls (p 0.04), respectively. A total of 26.1% of HCV-positive patients had signs of renal injury compared with 11.8% of HCV-negative controls (p 0.003). HCV infection was independently and significantly associated with the probability of worsening of renal function. The prevalence of microalbuminuria and renal insufficiency progressively increased with greater age. CONCLUSION: HCV-positive patients show a high prevalence of microalbuminuria and renal insufficiency compared with HCV-negative individuals. The risk of HCV-associated renal insufficiency is independent of the presence of other predisposing factors such hypertension and diabetes.