Direct-acting antiviral therapy improves kidney survival in hepatitis C virus-associated cryoglobulinaemia: the RENALCRYOGLOBULINEMIC study.

Autor: Pérez de José A; Department of Nephrology, University Hospital Gregorio Marañón, Madrid, Spain., Carbayo J; Department of Nephrology, University Hospital Gregorio Marañón, Madrid, Spain., Pocurull A; Department of Gastroenterology and Hepatology, Hospital Clínic de Barcelona, Barcelona, Spain., Bada-Bosch T; Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain., Cases Corona CM; Department of Nephrology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain., Shabaka A; Department of Nephrology, Hospital Clínico Universitario San Carlos, Madrid, Spain., Ramos Terrada N; Department of Nephrology, Hospital Vall d'Hebron, Barcelona, Spain., Martinez Valenzuela L; Department of Nephrology, Hospital Universitari de Bellvitge, Catalunya, Spain., Huerta A; Department of Nephrology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain., Fernandez Lorente L; Department of Nephrology, Hospital de Navarra, Pamplona, Spain., Malek-Marín TG; Department of Nephrology, Hospital de Sagunto, Sagunto, Spain., Goicoechea M; Department of Nephrology, University Hospital Gregorio Marañón, Madrid, Spain.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2020 Jan 25; Vol. 14 (2), pp. 586-592. Date of Electronic Publication: 2020 Jan 25 (Print Publication: 2021).
DOI: 10.1093/ckj/sfz178
Abstrakt: Background: Direct-acting antiviral agents (DAAs) have shown high rates of sustained virological response in chronic hepatitis C virus (HCV) infection. However, the influence of DAAs on the course of kidney involvement in HCV-associated mixed cryoglobulinaemia (HCV-MC) has been little studied. The aim of this study was to analyse the effects of antiviral treatment on kidney prognosis and evolution in patients diagnosed with HCV-MC.
Methods: The RENALCRYOGLOBULINEMIC study is an observational multicentre cohort study of 139 patients with HCV-MC from 14 Spanish centres. Clinical and laboratory parameters were measured before and after antiviral treatment. Primary endpoints were kidney survival and mortality after HCV-MC diagnosis. Secondary endpoints were clinical, immunological and virological responses after antiviral treatment.
Results: Patients were divided into three groups based on the treatment received: treatment with DAAs ( n  = 100) treatment with interferon (IFN) and ribavirin (RBV) ( n  = 24) and no treatment ( n  = 15). Patients were followed up for a median duration of 138 months (interquartile range 70-251. DAA treatment reduced overall mortality {hazard ratio [HR] 0.12 [95% confidence interval (CI) 0.04-0.40]; P < 0.001} and improved kidney survival [HR 0.10 ( 95% CI 0.04-0.33); P < 0.001].
Conclusions: Results from the RENALCRYOGLOBULINEMIC study indicated that DAA treatment in patients with HCV-MC improves kidney survival and reduces mortality.
(© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.)
Databáze: MEDLINE
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