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Minerva Urologica e Nefrologica 2014 June;66(2):139-49

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Hepatitis C virus infection and glomerular disease

Fabrizi F. 1, Donato F. 2, Messa P. 1

1 Division of Nephrology, Ospedale Maggiore IRCCS Foundation, Milan, Italy; 2 Division of Gastroenterology, Ospedale Maggiore IRCCS Foundation, Milan, Italy


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The association between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) is well established and remains an area of intense research. HCV infection is associated with a large spectrum of histo-pathological lesions in both native and transplanted kidneys. The frequency of kidney damage in HCV-infected patients appears low even if is not fully detailed. The most frequent HCV-associated renal lesion is type I membrano-proliferative glomerulonephritis, usually in the context of type II mixed cryoglobulinemia. Various approaches have been tried for the treatment of HCV-related glomerulonephritis, including immunosuppressive therapy (corticosteroids and cytotoxic agents), plasma exchange and antiviral agents. Antiviral treatment of HCV-associated glomerulonephritis has shown encouraging results. Immunosuppressive therapy is particularly recommended for cryoglobulinemic kidney disease. Two distinct approaches should be considered for the treatment of HCV-associated cryoglobulinemic glomerulonephritis according to the level of proteinuria and kidney failure. Some evidence on rituximab therapy for HCV-related cryoglobulinemic glomerulonephritis exists but several questions related to its use need to be addressed.

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