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. 2018 Sep 12;33(42):e264.
doi: 10.3346/jkms.2018.33.e264. eCollection 2018 Oct 15.

Chronic Hepatitis B Infection Is Significantly Associated with Chronic Kidney Disease: a Population-based, Matched Case-control Study

Sung-Eun Kim  1 , Eun Sun Jang  2 , Moran Ki  3 , Geum-Youn Gwak  4 , Kyung-Ah Kim  5 , Gi-Ae Kim  6 , Do Young Kim  7 , Dong Joon Kim  8 , Man Woo Kim  9 , Yun Soo Kim  10 , Young Seok Kim  11 , In Hee Kim  12 , Chang Wook Kim  13 , Ho Dong Kim  14 , Hyung Joon Kim  15 , Neung Hwa Park  16 , Soon Koo Baik  17 , Jeong Ill Suh  18 , Byung-Cheol Song  19 , Il Han Song  20 , Jong Eun Yeon  21 , Byung Seok Lee  22 , Youn Jae Lee  23 , Young Kul Jung  24 , Woo Jin Chung  25 , Sung Bum Cho  26 , Eun-Young Cho  27 , Hyun Chin Cho  28 , Gab Jin Cheon  29 , Hee Bok Chae  30 , DaeHee Choi  31 , Sung-Kyu Choi  32 , Hwa Young Choi  2 , Won Young Tak  33 , Jeong Heo  34 , Sook-Hyang Jeong  2
Affiliations

Chronic Hepatitis B Infection Is Significantly Associated with Chronic Kidney Disease: a Population-based, Matched Case-control Study

Sung-Eun Kim et al. J Korean Med Sci. .

Abstract

Background: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study.

Methods: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 or proteinuria as at least grade 2+ of urine protein.

Results: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m2 (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m2 along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m2.

Conclusion: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m2 and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.

Keywords: Chronic Renal Insufficiency; Glomerular Filtration Rate; Hepatitis B Virus; Proteinuria.

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Conflict of interest statement

Disclosure: The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Forest plot of the impact of the risk factors for a decreased GFR (GFR < 60 mL/min/m2). Age (P < 0.001), HbA1c (P < 0.001), BMI (P < 0.001), HBsAg positivity (P = 0.015), serum albumin (P < 0.001), serum bilirubin (P = 0.029), and anemia (P < 0.001) were the independent factors for a decreased GFR.
GFR = glomerular filtration rate, HbA1c = hemoglobin A1c, BMI = body mass index, HbsAg = hepatitis B virus surface antigen, OR = odds ratio, CI = confidence interval.
Fig. 2
Fig. 2. Forest plot of the impact of the risk factors for proteinuria (≥ 2+). HBsAg positivity (P < 0.001) was the independent risk factor of proteinuria along with age (P < 0.001), HbA1c (P < 0.001), male gender (P < 0.001), bilirubin (P < 0.001), albumin (P = 0.014), and total protein (P < 0.001).
HbsAg = hepatitis B virus surface antigen, HbA1c = hemoglobin A1c, OR = odds ratio, CI = confidence interval.
See this image and copyright information in PMC

Comment in

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