Long-term risk of end-stage renal diseases with maintenance dialysis among chronic hepatitis C patients after antiviral therapy in Taiwan

Meng-Hsuan Hsieh^{1

2

3

4}, Ming-Jong Bair⁵, Pei-Chien Tsai², Kuo-Chih Tseng⁶, Ching-Chu Lo⁷, Chi-Yi Chen⁸, Hsing-Tao Kuo⁹, Chao-Hung Hung¹⁰, Hsueh-Chou Lai¹¹, Cheng-Yuan Peng¹¹, Jing-Houng Wang¹², Jyh-Jou Chen¹³, Pei-Lun Lee¹³, Rong-Nan Chien¹⁴, Chi-Chieh Yang¹⁵, Gin-Ho Lo¹⁶, Jia-Horng Kao^{17

18}, Chun-Jen Liu^{17

18}, Chen-Hua Liu^{17

18}, Sheng-Lei Yan¹⁹, Chun-Yen Lin¹⁴, Wei-Wen Su²⁰, Cheng-Hsin Chu²¹, Chih-Jen Chen²¹, Shui-Yi Tung¹⁰, Chi-Ming Tai¹⁶, Chih-Wen Lin¹⁶, Pin-Nan Cheng²², Yen-Cheng Chiu²², Chia-Chi Wang²³, Jin-Shiung Cheng²⁴, Wei-Lun Tsai²⁴, Han-Chieh Lin²⁵, Yi-Hsiang Huang^{25

26}, Ming-Lun Yeh^{2

3}, Chung-Feng Huang^{2

3}, Jee-Fu Huang^{2

3}, Chia-Yen Dai^{2

3}, Ming-Lung Yu^{2

3}, Wan-Long Chuang^{2

3}; T-COACH investigators

Affiliations

¹ Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
² Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
³ School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Cancer Research and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁴ Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
⁵ Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan.
⁶ Department of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
⁷ Department of Internal Medicine, St. Martin De Porres Hospital - Daya, Chiayi, Taiwan.
⁸ Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan.
⁹ Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
¹⁰ Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Chiayi, Taiwan.
¹¹ Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
¹² Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹³ Division of Gastroenterology and Hepatology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
¹⁴ Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
¹⁵ Division of Gastroenterology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
¹⁶ Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
¹⁷ Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
¹⁸ Division of Gastroenterology and Hepatology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁹ Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show-Chwan Memorial Hospital, Changhua, Taiwan.
²⁰ Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
²¹ Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
²² Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
²³ Division of Gastroenterology, Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, New Taipei City, School of Medicine, Tzu Chi University, Hualien, Taiwan.
²⁴ Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
²⁵ Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
²⁶ Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.

PMID: 33624849
DOI: 10.1111/jgh.15469

Long-term risk of end-stage renal diseases with maintenance dialysis among chronic hepatitis C patients after antiviral therapy in Taiwan

Meng-Hsuan Hsieh et al. J Gastroenterol Hepatol. 2021 Aug.

. 2021 Aug;36(8):2247-2254.

doi: 10.1111/jgh.15469. Epub 2021 Mar 30.

Authors

Affiliations

¹ Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
² Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
³ School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Cancer Research and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁴ Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
⁵ Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan.
⁶ Department of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
⁷ Department of Internal Medicine, St. Martin De Porres Hospital - Daya, Chiayi, Taiwan.
⁸ Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan.
⁹ Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
¹⁰ Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Chiayi, Taiwan.
¹¹ Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
¹² Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹³ Division of Gastroenterology and Hepatology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
¹⁴ Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
¹⁵ Division of Gastroenterology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
¹⁶ Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
¹⁷ Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
¹⁸ Division of Gastroenterology and Hepatology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁹ Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show-Chwan Memorial Hospital, Changhua, Taiwan.
²⁰ Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
²¹ Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
²² Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
²³ Division of Gastroenterology, Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, New Taipei City, School of Medicine, Tzu Chi University, Hualien, Taiwan.
²⁴ Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
²⁵ Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
²⁶ Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.

PMID: 33624849
DOI: 10.1111/jgh.15469

Abstract

Background and aim: Chronic hepatitis C virus (HCV) infection is associated with impaired renal function. The aim of this study is to explore the risk of and factors associated with end-stage renal diseases (ESRD) under maintenance dialysis among HCV patients after anti-HCV therapy.

Methods: A total of 12 696 HCV-infected patients with interferon-based therapy, including 9679 (76.2%) achieving sustained virological response (SVR), were enrolled from 23 hospitals in Taiwan.

Results: During a mean follow-up period of 5.3 years (67 554 person-years), the annual incidence of 4.1/10 000 person-years, 4.0/10 000 and 4.7/10 000 person-years among SVR patients and non-SVR patients, respectively. History of diabetes and baseline estimated glomerular filtration rate < 60 mL/min/m² , instead of SVR, were the significant risk factors for developing ESRD with maintenance dialysis after anti-HCV therapy (adjusted hazard ratio 7.75 and 9.78).

Conclusion: Diabetes and baseline impaired renal function were strongly associated with progression to ESRD with maintenance dialysis among chronic HCV-infected patients after antiviral therapy.

Keywords: chronic kidney disease; end-stage renal disease; hepatitis C virus; interferon.

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References

1. EASL. Recommendations on Treatment of Hepatitis C 2018. J. Hepatol. 2018; 69: 461-511.
1. Omata M, Kanda T, Wei L et al. APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing. Hepatol Int. 2016; 10: 681-701.
1. Negro F, Forton D, Craxi A, Sulkowski MS, Feld JJ, Manns MP. Extrahepatic morbidity and mortality of chronic hepatitis C. Gastroenterology 2015; 149: 1345-1360.
1. Huang JF, Yu ML, Dai CY, Chuang WL. Glucose abnormalities in hepatitis C virus infection. Kaohsiung J. Med. Sci. 2013; 29: 61-68.
1. Hsu YC, Lin JT, Ho HJ et al. Antiviral treatment for hepatitis C virus infection is associated with improved renal and cardiovascular outcomes in diabetic patients. Hepatology 2014; 59: 1293-1302.

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Long-term risk of end-stage renal diseases with maintenance dialysis among chronic hepatitis C patients after antiviral therapy in Taiwan

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Long-term risk of end-stage renal diseases with maintenance dialysis among chronic hepatitis C patients after antiviral therapy in Taiwan

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