J Korean Med Assoc.  2020 Jan;63(1):14-19. 10.5124/jkma.2020.63.1.14.

Kidney disease in patients with chronic liver disease

Affiliations
  • 1Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. jhchang@gilhospital.com

Abstract

The kidneys are closely connected with several organs, including the liver, and can therefore be negatively affected when the liver is damaged. The most common cause of chronic liver disease is chronic viral hepatitis, resulting from either a hepatitis B virus (HBV) or a hepatitis C virus (HCV). Chronic viral hepatitis often progresses to cirrhosis and hepatocellular carcinoma. However, it can also lead to viral-associated glomerulopathies that can cause chronic kidney disease (CKD), which can then progress to end stage renal disease (ESRD). Additionally, patients with ESRD on hemodialysis are at risk for viral infections because HBV and HCV are hematogenously transmitted. Recently, treatments with oral nucleoside/nucleotide analogues and direct-acting antivirals have yielded excellent results in HBV- and HCV-infected patients with CKD. As a result, a new paradigm for the treatment of chronic viral infections in CKD patients has emerged. This review discusses viral-associated glomerulopathies, antiviral treatments of HBV and HCV infections in patients with CKD, and prevention strategies for the transmission of HBV and HCV in patients with ESRD.

Keyword

Chronic disease; Liver diseases; Hepatitis B virus; Hepatitis C virus; Kidney diseases

MeSH Terms

Antiviral Agents
Carcinoma, Hepatocellular
Chronic Disease
Fibrosis
Hepacivirus
Hepatitis
Hepatitis B virus
Humans
Kidney Diseases*
Kidney Failure, Chronic
Kidney*
Liver Diseases*
Liver*
Renal Dialysis
Renal Insufficiency, Chronic
Antiviral Agents
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