Renal Impairment in Chronic Hepatitis B: A Review

Abstract

The liver plays a key role in the metabolism of proteins. Liver dysfunction affects many organs because it communicates with the spleen and all digestive organs through the portal vein. Additionally, the kidney is an organ that is closely related to the liver and is involved in liver diseases. Glomerulonephritis is an important extrahepatic manifestation of chronic hepatitis B virus (HBV) infection. Nucleos(t)ide analog (NA) therapy effectively suppresses HBV replication by inhibiting HBV polymerase, thus decreasing the levels of serum HBV-DNA and delaying the progression of cirrhosis. Although NA therapy is recommended for all patients with chronic HBV infection, regardless of the level of renal dysfunction, there is limited information on NA use in patients with chronic kidney disease. In addition, in patients with end-stage liver cirrhosis, hepatorenal syndrome can be fatal. Hence, we should take into account the stage of impaired renal function in patients with cirrhosis. The aims of this article are to review the epidemiology, clinical presentation, treatment, and prevention of HBV-associated nephropathy.

The Pattern of viral seromarkers in patients with elevated plasma creatinine of ≥ 3.5mg/dl

“…[9][10][11][12] Furthermore, the findings can also be explained as follows that the extrahepatic manifestations of chronic hepatitis B virus (HBV) infection include glomerulonephritis. 13,14 In addition, extrahepatic manifestations and complications of HCV infection also include mixed cryoglobulinemia, lymphoproliferative disorders, and kidney disease. [15][16][17][18][19][20][21][22][23][24][25][26][27] Chronic hepatitis C virus infection has been linked with a glomerular disease like mixed cryoglobulinemia, membranoproliferative glomerulonephritis, membranous nephropathy, and polyarteritis nodosa.…”

Focal Segmental Glomerulosclerosis caused by Hepatitis B Infection Comorbid with HIV Infection

“…Patient was not diagnosed with HIVAN because HIVAN usually occurs at an advanced stage of HIV infection, accompanied by low CD4 cell counts and high level of HIV-RNA viral load, while in this case, the patient was still in the early stages of HIV infection accompanied by high CD4 cell counts and low level of HIV-RNA viral load. 8 With high level of HBV-DNA and incompatibility of the course of this disease with HIVAN, we diagnosed patient with nephropathy due to hepatitis B infection. In one study, it was proved that high level of HBV-DNA increases glomerular damage and proteinuria.…”

“…High level of HBV-DNA represents high viral replication and high release of virus into the blood circulation. 2,8 Based on the 2012 KDIGO guidelines, treatment of FSGS due to hepatitis B is interferon or nucleoside analogues. Several drugs are already available such as lamivudine, adefovir, entecavir, telbivudine and tenofovir.…”

“…Dari pemeriksaan biopsi ginjal, kami menemukan lesi focal segmental glomerulosclerosis. Dari pemeriksaan darah, kami temukan pasien memiliki infeksi hepatitis B dengan kadar HBV-DNA > 1.7x10 8 IU/mL dan infeksi HIV dengan kadar…”

Human hepatitis viruses-associated cutaneous and systemic vasculitis

“…The use of corticosteroids without NA therapy is ineffective for suppression of HBV viremia, resulting in refractory or relapsing disease[ 121 ]. Nevertheless, only a portion of patients with severe disease, including peripheral neuropathy and renal involvement, can achieve clinical regression under NA therapy[ 70 , 123 , 125 ]. CD20-positive B-cells are expanded and activated in mixed cryogobulinemia, and they participate in the production of cryoglobulins[ 126 ].…”