Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Fabrizi, Fabrizio; Aghemo, Alessio; Fogazzi, Giovanni B.; Moroni, Gabriella; Passerini, Patrizia; D’Ambrosio, Roberta

doi:10.1159/000355753

Cited by 12 publications

(10 citation statements)

References 38 publications

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“…Ribavirin renal toxicity has not been documented and is not probable in monotherapy[65,66]. Nevertheless, by analogy with the ribavirin apoptotic activity observed in K562 leukemia cells, potential tubular toxicity has been hypothesized[65,67].…”

Section: Specific Nephrotoxicity Of Hcv Drugsmentioning

confidence: 99%

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Anti-hepatitis C virus drugs and kidney

Carrier

Essig

Debette-Gratien

et al. 2016

WJH

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Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin. The first results were convincing. To aid in the correct use of these drugs in patients with renal insufficiency, their pharmacokinetic properties and potential renal toxicity must be known. The renal toxicity of these new drugs was not a safety signal in clinical trials, and the drugs are generally efficient in these frail populations. These drugs are usually well tolerated, but recent cohort studies have demonstrated that these new regimens may be associated with renal side effects, especially when using sofosbuvir combinations. HCV, renal diseases and comorbidities are intimately linked. The close monitoring of renal function is required, particularly for at-risk patients (transplanted, HIV-coinfected, CKD, hypertensive or diabetic patients). New DAA regimens, which will soon be approved, will probably change the landscape.

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Section: Specific Nephrotoxicity Of Hcv Drugsmentioning

confidence: 99%

“…Nevertheless, by analogy with the ribavirin apoptotic activity observed in K562 leukemia cells, potential tubular toxicity has been hypothesized[65,67]. …”

Section: Specific Nephrotoxicity Of Hcv Drugsmentioning

confidence: 99%

Anti-hepatitis C virus drugs and kidney

Carrier

Essig

Debette-Gratien

et al. 2016

WJH

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“…Recombinant IFN given for treatment of HCV may exacerbate proteinuria in some patients with underlying glomerulopathies. 323 Regardless of the regimens used (IFN-based or DAAs), antiviral treatment of HCV-related glomerular disease has limitations. First, the impact of antiviral therapy on the longterm outcomes of kidney disease remains uncertain.…”

Section: 2mentioning

confidence: 99%

KDIGO 2018 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease

2019

N&D

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of recommendation statements 108 Chapter 1: Detection and evaluation of HCV in CKD 114 Chapter 2: Treatment of HCV infection in patients with CKD 121 Chapter 3: Preventing HCV transmission in hemodialysis units 130 Chapter 4: Management of HCV-infected patients before and after kidney transplantation 137 Chapter 5: Diagnosis and management of kidney diseases associated with HCV infection 142 Methods for guideline development 151 Biographic and disclosure information 157 Acknowledgments 158 References The development and publication of this guideline were supported by KDIGO. The opinions or views expressed in this professional education supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources. Because of the differences between in vitro and in vivo systems and between laboratory animal models and clinical data in humans, in vitro and animal data may not necessarily correlate with clinical results.

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“…Nephrotoxicity is unusual during treatment; however, there are case reports of acute tubular necrosis induced by PEG [2]. There are also reports of proteinuria induced by this regimen, which disappear after the cessation of treatment.…”

Section: Doi: 101159/000493807mentioning

confidence: 99%

Incidence and Characteristics of de novo Renal Cryoglobulinemia After Direct-Acting Antivirals Treatment in an Egyptian Hepatitis C Cohort

Nokeety

Abdelaziz

Samir

et al. 2018

Nephron

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Introduction: The side effects profile of the new direct-acting antivirals for the treatment of hepatitis C virus (HCV) is not fully elucidated. Objective: In this cross-sectional study, we aim to describe the incidence and characteristics of a novel observation of de novo renal cryoglobulinemic glomerulonephritis after successful treatment with DAA. Methodology: A total of 12,985 Hepatitis C Patients (genotype IV) received the new DAA. After successful treatment, patients with deranged renal functions or proteinuria were referred to the nephrology department for assessment. The clinical manifestations ranged from lower limb edema to the development of purpura skin lesions. Cryoglobulins were tested in the serum using the PCR detection. Results: Fifty patients had detectable de novo cryoglobulins in the serum. The most common type in renal biopsies was membranoproliferative glomerulonephritis (52%) and chronic kidney disease (CKD) developed in 46% of cases. Conclusion: De novo cryoglobulinemic glomerulonephritis and progression to CKD may rarely complicate successful treatment of HCV using direct-acting antivirals.

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Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Cited by 12 publications

References 38 publications

Anti-hepatitis C virus drugs and kidney

Anti-hepatitis C virus drugs and kidney

KDIGO 2018 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease

Incidence and Characteristics of de novo Renal Cryoglobulinemia After Direct-Acting Antivirals Treatment in an Egyptian Hepatitis C Cohort

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