HCV-Associated Nephropathies in the Era of Direct Acting Antiviral Agents

Angeletti, Andrea; Cantarelli, Chiara; Cravedi, Paolo

doi:10.3389/fmed.2019.00020

Cited by 23 publications

(18 citation statements)

References 107 publications

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“…Chronic HCV infection also causes several immunemediated glomerular disorders, including podocytopathy with FSGS lesions 106,107 . Although the pathogenic mechanisms are unclear, it is hypothesized that, similar to HIV, HCV directly injures podocytes, leading to glomerulosclerosis 107 .…”

Section: Syndromic Disordersmentioning

confidence: 99%

“…Although the pathogenic mechanisms are unclear, it is hypothesized that, similar to HIV, HCV directly injures podocytes, leading to glomerulosclerosis 107 . Eliminating HCV using antiviral medications can clear the virus from >95% of individuals with chronic HCV infection and improve the outcome by reducing proteinuria and preventing or delaying CKD 106 .…”

Section: Syndromic Disordersmentioning

confidence: 99%

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Podocytopathies

Kopp

Anders

Suszták

et al. 2020

Nat Rev Dis Primers

305

270

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Podocytopathies are kidney diseases in which direct or indirect podocyte injury drives proteinuria or nephrotic syndrome. In children and young adults, genetic variants in >50 podocyte-expressed genes, syndromal non-podocyte-specific genes and phenocopies with other underlying genetic abnormalities cause podocytopathies associated with steroid-resistant nephrotic syndrome or severe proteinuria. A variety of genetic variants likely contribute to disease development. Among genes with non-Mendelian inheritance, variants in APOL1 have the largest effect size. In addition to genetic variants, environmental triggers such as immune-related, infection-related, toxic and haemodynamic factors and obesity are also important causes of podocyte injury and frequently combine to cause various degrees of proteinuria in children and adults. Typical manifestations on kidney biopsy are minimal change lesions and focal segmental glomerulosclerosis lesions. Standard treatment for primary podocytopathies manifesting with focal segmental glomerulosclerosis lesions includes glucocorticoids and other immunosuppressive drugs; individuals not responding with a resolution of proteinuria have a poor renal prognosis. Renin-angiotensin system antagonists help to control proteinuria and slow the progression of fibrosis. Symptomatic management may include the use of diuretics, statins, infection prophylaxis and anticoagulation. This Primer discusses a shift in paradigm from patient stratification based on kidney biopsy findings towards personalized management based on clinical, morphological and genetic data as well as pathophysiological understanding.

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Section: Syndromic Disordersmentioning

confidence: 99%

Section: Syndromic Disordersmentioning

confidence: 99%

Podocytopathies

Kopp

Anders

Suszták

et al. 2020

Nat Rev Dis Primers

305

270

View full text Add to dashboard Cite

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“…The IF usually shows IgM and C3 staining in the capillary walls with intracapillary thrombi positive for IgM and, kappa and lambda chains. Electron microscopy shows subendothelial and mesangial deposits 9 …”

Section: Discussionmentioning

confidence: 99%

Hepatitis C–associated focal proliferative glomerulonephritis in an aviremic recipient of a hepatitis C–positive antibody donor liver

Bohórquez

Lusco

Scheuermann

et al. 2021

American Journal of Transplantation

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Shortage of organs for liver transplantation (LT) and the availability of highly efficient pan‐genotypic direct‐acting antivirals (DAAs) against hepatitis C virus (HCV) have allowed the use of livers from HCV‐positive antibody/negative nucleic acid test donors (dHCV Ab+/NAT−) into aviremic HCV recipients over the last few years. We report the case of a patient who received an LT from an HCV Ab+/NAT− donor and, after HCV viremic conversion, developed a nephrotic syndrome due to a focal proliferative glomerulonephritis early after LT. Patient's renal function and proteinuria resolved after successful treatment with DAAs. Renal and hepatic function remain normal over 24 months of follow‐up. This case restates the success of LT using livers from dHCV Ab+/NAT− in aviremic recipients in the context of DAAs while illustrating the risk for potential complications associated with the HCV transmission and reinforcing the importance of early initiation of anti‐HCV therapy.

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“…Seltenere Ursachen der mit Hepatitis C assoziierten Nierenerkrankungen sind die Fibrilläre Glomerulonephritis, die IgA-Nephropathie und die fokal segmentale Glomerulosklerose [166].…”

Section: Mit Hepatitis-c-virus Assoziierte Nierenerkrankungenunclassified

Ursachen der chronischen Nierenschädigung in Patienten mit Lebererkrankungen – Pathophysiologie und Therapiemöglichkeiten

et al. 2021

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ZusammenfassungEine akute oder chronische Nierenschädigung bei gleichzeitig bestehender Lebererkrankung stellt ein häufiges Problem dar und geht im weiteren klinischen Verlauf mit zahlreichen Komplikationen sowie einer gesteigerten Dialysepflichtigkeit und Mortalität einher.Die Prävalenz einer chronischen Niereninsuffizienz (CNI) bei Patienten mit Lebererkrankungen ist hoch, nicht zuletzt wegen parallel bestehender Komorbiditäten (z. B. metabolisches Syndrom, chronische Entzündungsprozesse, Hyperkoagulabilität, Hyperfibrinolyse, Diabetes mellitus, Dyslipidämie usw.). Doch nicht jede chronische Verschlechterung der Nierenretentionsparameter lässt sich auf ein hepatorenales Syndrom zurückführen. Neben diesem sind die häufigsten Ursachen der CNI bei bestehenden Lebererkrankungen die diabetische Nephropathie, die alkoholassoziierte IgA-Nephropathie, die mit Hepatitis C assoziierte membranoproliferative Glomerulonephritis und die mit Hepatitis B assoziierte membranöse Glomerulonephritis.Koexistente Erkrankungen, ähnlich bzw. parallel ablaufende pathophysiologische Mechanismen und überlappende Erscheinungsbilder stellen hinsichtlich der Ursachenfindung und entsprechenden Behandlung der CNI im Rahmen einer existenten Lebererkrankung eine Herausforderung an den Kliniker dar. Diese Übersichtsarbeit skizziert sowohl häufige als auch seltene Entitäten, die zu einer chronischen Nierenschädigung in diesem speziellen Patientenkollektiv führen, und zeigt einen Überblick zu therapeutischen Möglichkeiten.

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HCV-Associated Nephropathies in the Era of Direct Acting Antiviral Agents

Cited by 23 publications

References 107 publications

Podocytopathies

Podocytopathies

Hepatitis C–associated focal proliferative glomerulonephritis in an aviremic recipient of a hepatitis C–positive antibody donor liver

Ursachen der chronischen Nierenschädigung in Patienten mit Lebererkrankungen – Pathophysiologie und Therapiemöglichkeiten

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