Changes in the estimated renal function after hepatitis C virus eradication with direct-acting antiviral agents: Impact of changes in skeletal muscle mass.
Yoshimasa TokuchiGoki SudaMegumi KimuraOsamu MaeharaTakashi KitagatayaMasatsugu OharaRen YamadaTaku ShigesawaKazuharu SuzukiNaoki KawagishiMasato NakaiTakuya ShoMitsuteru NatsuizakaKenichi MorikawaKoji OgawaNaoya SakamotoPublished in: Journal of viral hepatitis (2021)
Hepatitis C virus (HCV) infection can cause renal dysfunction, expected to improve upon HCV eradication. However, adverse effects of HCV eradication using direct-acting antiviral agents (DAAs) on renal function have been recently reported. This retrospective study aimed to evaluate renal function with glomerular filtration rate (eGFR) estimated using creatinine (eGFRcre) and cystatin C (eGFRcys). Complete clinical information and preserved serum samples were collected from 207 patients with HCV infection treated with interferon-free DAA at baseline and SVR48 (SVR48). Patients who underwent paired computed tomography (CT) at baseline and ≥12 months after DAA were evaluated for changes in skeletal muscle mass using the psoas muscle mass index (PMI). eGFRcre significantly worsened at SVR48, while eGFRcys was similar at baseline and SVR48. At baseline, eGFRcre was significantly higher than eGFRcys; eGFRcre and eGFRcys were similar at SVR48. Multivariate analysis revealed that the presence of liver cirrhosis and low-albumin level, as well as cirrhosis and age, was significantly associated with the overestimation of renal function by eGFRcre at baseline and SVR48, respectively. In the 57 patients who underwent paired CT at baseline and ≥12 months after DAA, relative values of PMI significantly increased after DAA. After DAA, in patients with increased PMI (65% 37/57), eGFRcre significantly worsened but did not change in patients without increased PMI. eGFRcre significantly worsened after DAAs; however, this might not reflect accurate changes in renal function, partially because of changes in skeletal muscle mass. eGFRcys did not change after DAAs, and it is a potential alternative to eGFRcre.
Keyphrases
- hepatitis c virus
- computed tomography
- end stage renal disease
- newly diagnosed
- human immunodeficiency virus
- ejection fraction
- skeletal muscle
- chronic kidney disease
- healthcare
- small cell lung cancer
- helicobacter pylori infection
- patient reported outcomes
- metabolic syndrome
- positron emission tomography
- insulin resistance
- magnetic resonance
- risk assessment
- immune response
- image quality
- emergency department
- hiv infected
- climate change
- antiretroviral therapy
- pet ct
- data analysis
- drug induced