Achieving Sustained Virological Response in Liver Transplant Recipients With Hepatitis C Decreases Risk of Decline in Renal Function

Sanjaya Satapathy, Kiran Joglekar, Miklos Z. Molnar, Bilal Ali, Humberto C. Gonzalez, Jason M. Vanatta, James D. Eason, Satheesh P. Nair

Research output: Contribution to journalArticle

  • 1 Citations

Abstract

The effect of antiviral therapy (AVT) on kidney function in liver transplantation (LT) recipients has not been well described despite known association of hepatitis C virus (HCV) infection with chronic kidney disease (CKD). We compared the incidence of CKD and end-stage renal disease (ESRD) in 204 LT recipients with HCV based on treatment response to AVT. The mean estimated glomerular filtration rate (eGFR) at baseline (3 months after LT) was similar in the sustained virological response (SVR; n = 145) and non-SVR group (n = 59; 69 ± 21 versus 65 ± 33 mL/minute/1.73 m2; P = 0.27). In the unadjusted Cox proportional regression analysis, the presence of SVR was associated with an 88% lower risk of CKD (hazard ratio, 0.12; 95% confidence interval [CI], 0.05-0.31) and 86% lower risk of ESRD (odds ratio, 0.14; 95% CI, 0.05-0.35). Similar results were found after adjusting for propensity score and time-dependent Cox regression analyses. The estimated slopes of eGFR based on a 2-stage mixed model of eGFR were calculated. Patients with SVR had a less steep slope in eGFR (–0.60 mL/minute/1.73 m2/year; 95% CI, –1.50 to 0.30; P = 0.190) than recipients without SVR (–2.53 mL/minute/1.73 m2/year; 95% CI, –3.99 to –1.07; P = 0.001), and the differences in the slopes were statistically significant (P = 0.026). In conclusion, in LT recipients with chronic HCV infection, achieving SVR significantly lowers the risk of decline in renal function and progression to ESRD independent of the AVT therapy used.

LanguageEnglish (US)
Pages1040-1049
Number of pages10
JournalLiver Transplantation
Volume24
Issue number8
DOIs
StatePublished - Aug 1 2018

Fingerprint

Hepatitis C
Glomerular Filtration Rate
Liver Transplantation
Kidney
Chronic Renal Insufficiency
Hepacivirus
Liver
Confidence Intervals
Chronic Kidney Failure
Antiviral Agents
Virus Diseases
Regression Analysis
Therapeutics
Propensity Score
Chronic Hepatitis C
Odds Ratio
Transplant Recipients
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Achieving Sustained Virological Response in Liver Transplant Recipients With Hepatitis C Decreases Risk of Decline in Renal Function. / Satapathy, Sanjaya; Joglekar, Kiran; Molnar, Miklos Z.; Ali, Bilal; Gonzalez, Humberto C.; Vanatta, Jason M.; Eason, James D.; Nair, Satheesh P.

In: Liver Transplantation, Vol. 24, No. 8, 01.08.2018, p. 1040-1049.

Research output: Contribution to journalArticle

Satapathy, Sanjaya ; Joglekar, Kiran ; Molnar, Miklos Z. ; Ali, Bilal ; Gonzalez, Humberto C. ; Vanatta, Jason M. ; Eason, James D. ; Nair, Satheesh P. / Achieving Sustained Virological Response in Liver Transplant Recipients With Hepatitis C Decreases Risk of Decline in Renal Function. In: Liver Transplantation. 2018 ; Vol. 24, No. 8. pp. 1040-1049.
@article{c1bb4a8d2954466eb86527b06bcdb1fe,
title = "Achieving Sustained Virological Response in Liver Transplant Recipients With Hepatitis C Decreases Risk of Decline in Renal Function",
abstract = "The effect of antiviral therapy (AVT) on kidney function in liver transplantation (LT) recipients has not been well described despite known association of hepatitis C virus (HCV) infection with chronic kidney disease (CKD). We compared the incidence of CKD and end-stage renal disease (ESRD) in 204 LT recipients with HCV based on treatment response to AVT. The mean estimated glomerular filtration rate (eGFR) at baseline (3 months after LT) was similar in the sustained virological response (SVR; n = 145) and non-SVR group (n = 59; 69 ± 21 versus 65 ± 33 mL/minute/1.73 m2; P = 0.27). In the unadjusted Cox proportional regression analysis, the presence of SVR was associated with an 88{\%} lower risk of CKD (hazard ratio, 0.12; 95{\%} confidence interval [CI], 0.05-0.31) and 86{\%} lower risk of ESRD (odds ratio, 0.14; 95{\%} CI, 0.05-0.35). Similar results were found after adjusting for propensity score and time-dependent Cox regression analyses. The estimated slopes of eGFR based on a 2-stage mixed model of eGFR were calculated. Patients with SVR had a less steep slope in eGFR (–0.60 mL/minute/1.73 m2/year; 95{\%} CI, –1.50 to 0.30; P = 0.190) than recipients without SVR (–2.53 mL/minute/1.73 m2/year; 95{\%} CI, –3.99 to –1.07; P = 0.001), and the differences in the slopes were statistically significant (P = 0.026). In conclusion, in LT recipients with chronic HCV infection, achieving SVR significantly lowers the risk of decline in renal function and progression to ESRD independent of the AVT therapy used.",
author = "Sanjaya Satapathy and Kiran Joglekar and Molnar, {Miklos Z.} and Bilal Ali and Gonzalez, {Humberto C.} and Vanatta, {Jason M.} and Eason, {James D.} and Nair, {Satheesh P.}",
year = "2018",
month = "8",
day = "1",
doi = "10.1002/lt.25059",
language = "English (US)",
volume = "24",
pages = "1040--1049",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "8",

}

TY - JOUR

T1 - Achieving Sustained Virological Response in Liver Transplant Recipients With Hepatitis C Decreases Risk of Decline in Renal Function

AU - Satapathy, Sanjaya

AU - Joglekar, Kiran

AU - Molnar, Miklos Z.

AU - Ali, Bilal

AU - Gonzalez, Humberto C.

AU - Vanatta, Jason M.

AU - Eason, James D.

AU - Nair, Satheesh P.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - The effect of antiviral therapy (AVT) on kidney function in liver transplantation (LT) recipients has not been well described despite known association of hepatitis C virus (HCV) infection with chronic kidney disease (CKD). We compared the incidence of CKD and end-stage renal disease (ESRD) in 204 LT recipients with HCV based on treatment response to AVT. The mean estimated glomerular filtration rate (eGFR) at baseline (3 months after LT) was similar in the sustained virological response (SVR; n = 145) and non-SVR group (n = 59; 69 ± 21 versus 65 ± 33 mL/minute/1.73 m2; P = 0.27). In the unadjusted Cox proportional regression analysis, the presence of SVR was associated with an 88% lower risk of CKD (hazard ratio, 0.12; 95% confidence interval [CI], 0.05-0.31) and 86% lower risk of ESRD (odds ratio, 0.14; 95% CI, 0.05-0.35). Similar results were found after adjusting for propensity score and time-dependent Cox regression analyses. The estimated slopes of eGFR based on a 2-stage mixed model of eGFR were calculated. Patients with SVR had a less steep slope in eGFR (–0.60 mL/minute/1.73 m2/year; 95% CI, –1.50 to 0.30; P = 0.190) than recipients without SVR (–2.53 mL/minute/1.73 m2/year; 95% CI, –3.99 to –1.07; P = 0.001), and the differences in the slopes were statistically significant (P = 0.026). In conclusion, in LT recipients with chronic HCV infection, achieving SVR significantly lowers the risk of decline in renal function and progression to ESRD independent of the AVT therapy used.

AB - The effect of antiviral therapy (AVT) on kidney function in liver transplantation (LT) recipients has not been well described despite known association of hepatitis C virus (HCV) infection with chronic kidney disease (CKD). We compared the incidence of CKD and end-stage renal disease (ESRD) in 204 LT recipients with HCV based on treatment response to AVT. The mean estimated glomerular filtration rate (eGFR) at baseline (3 months after LT) was similar in the sustained virological response (SVR; n = 145) and non-SVR group (n = 59; 69 ± 21 versus 65 ± 33 mL/minute/1.73 m2; P = 0.27). In the unadjusted Cox proportional regression analysis, the presence of SVR was associated with an 88% lower risk of CKD (hazard ratio, 0.12; 95% confidence interval [CI], 0.05-0.31) and 86% lower risk of ESRD (odds ratio, 0.14; 95% CI, 0.05-0.35). Similar results were found after adjusting for propensity score and time-dependent Cox regression analyses. The estimated slopes of eGFR based on a 2-stage mixed model of eGFR were calculated. Patients with SVR had a less steep slope in eGFR (–0.60 mL/minute/1.73 m2/year; 95% CI, –1.50 to 0.30; P = 0.190) than recipients without SVR (–2.53 mL/minute/1.73 m2/year; 95% CI, –3.99 to –1.07; P = 0.001), and the differences in the slopes were statistically significant (P = 0.026). In conclusion, in LT recipients with chronic HCV infection, achieving SVR significantly lowers the risk of decline in renal function and progression to ESRD independent of the AVT therapy used.

UR - http://www.scopus.com/inward/record.url?scp=85052210168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052210168&partnerID=8YFLogxK

U2 - 10.1002/lt.25059

DO - 10.1002/lt.25059

M3 - Article

VL - 24

SP - 1040

EP - 1049

JO - Liver Transplantation

T2 - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 8

ER -