Influencing factors for chronic kidney disease in patients with hepatitis B cirrhosis

Li YANG; Ke SHI; Fangyuan GAO; Chongping RAN; Jie HOU; Xianbo WANG

doi:10.3969/j.issn.1001-5256.2021.08.015

Volume 37 Issue 8

Aug. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(8): 1817-1821

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Influencing factors for chronic kidney disease in patients with hepatitis B cirrhosis

DOI: 10.3969/j.issn.1001-5256.2021.08.015

Li YANG¹,
Ke SHI^{1, 2},
Fangyuan GAO¹,
Chongping RAN¹,
Jie HOU^{1, 2},
Xianbo WANG^{1
,
,}

1.
Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
2.
The First Clinical Medical College of Beijing University of Chinese Medicine, Beijing 100700, China

Research funding:

Capital Health Development Research Project (2018-1-2172);

Beijing Municipal Commission of Science and Technology (Z191100006619033);

National Administration of Traditional Chinese Medicine Clinical Cooperation Pilot Project of Traditional Chinese and Western Medicine for Major and Difficult Diseases (2018-6-4);

Regional TCM Diagnosis and Treatment Center Construction Project of State Administration of Traditional Chinese Medicine (2019-3-18)

Received Date: 2021-01-03
Accepted Date: 2021-01-26
Published Date: 2021-08-20

Abstract

Abstract

Objective To investigate the influencing factors for chronic kidney disease (CKD) in patients with hepatitis B cirrhosis within 3 years. Methods A total of 376 patients with hepatitis B cirrhosis who attended Beijing Ditan Hospital, Capital Medical University, from January 2014 to July 2017 were enrolled and followed up for 3 years, and according to the presence or absence of CKD, they were divided into CKD group with 23 patients and non-CKD group with 353 patients. Related general information and laboratory markers were collected. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups; a stepwise forward Cox regression analysis was used to screen out the independent influencing factors for CKD within 3 years in patients with hepatitis B cirrhosis. The area under the receiver operating characteristic curve (AUC) was used to investigate the value of the influencing factors in predicting CKD in patients with hepatitis B cirrhosis; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of the cumulative incidence rate of CKD between the patients with different risks. Results The multivariate Cox regression analysis showed that age (hazard ratio [HR]=1.078, 95% confidence interval [CI]: 1.007-1.114, P=0.026), albumin (Alb) (HR=0.923, 95% CI: 0.860-0.989, P=0.024), and estimated glomerular filtration rate (eGFR) (HR=0.977, 95% CI: 0.955-0.999, P=0.037) were independent influencing factors for CKD within 3 years in patients with hepatitis B cirrhosis. Age, Alb, and eGFR had a relatively good value in predicting CKD, with AUCs of 0.701, 0.710, and 0.706, respectively. The Kaplan-Meier survival curve showed that the patients with baseline age ≥55 years, Alb < 32 g/L, and eGFR ≥60 ml·min^-1·1.73 m^-2 and < 76 ml·min^-1·1.73 m^-2 had a higher risk of CKD (χ²=9.647, 13.621, and 30.940, all P < 0.05). Conclusion Renal function should be closely monitored for patients with old age and low Alb and eGFR levels.
- Liver Cirrhosis,
- Kidney Diseases,
- Root Cause Analysis

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References

[1]	FABRIZI F, CERUTTI R, RIDRUEJO E. Hepatitis B virus infection as a risk factor for chronic kidney disease[J]. Expert Rev Clin Pharmacol, 2019, 12(9): 867-874. DOI: 10.1080/17512433.2019.1657828.
[2]	HONG YS, RYU S, CHANG Y, et al. Hepatitis B virus infection and development of chronic kidney disease: A cohort study[J]. BMC Nephrol, 2018, 19(1): 353. DOI: 10.1186/s12882-018-1154-4.
[3]	CHACKO EC, SURRUN SK, MUBARACK SANI TP, et al. Chronic viral hepatitis and chronic kidney disease[J]. Postgrad Med J, 2010, 86(1018): 486-492. DOI: 10.1136/pgmj.2009.092775.
[4]	GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2020, 395(10225): 709-733. DOI: 10.1016/S0140-6736(20)30045-3.
[5]	Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007. 中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
[6]	Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006. 中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
[7]	STEVENS PE, LEVIN A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: Synopsis of the kidney disease: Improving global outcomes 2012 clinical practice guideline[J]. Ann Intern Med, 2013, 158(11): 825-830. DOI: 10.7326/0003-4819-158-11-201306040-00007.
[8]	LEVEY AS, BOSCH JP, LEWIS JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group[J]. Ann Intern Med, 1999, 130(6): 461-470. DOI: 10.7326/0003-4819-130-6-199903160-00002.
[9]	CARNEY EF. Glomerular filtration rate: CKD risk factors are associated with increased single-nephron GFR[J]. Nat Rev Nephrol, 2017, 13(8): 443. DOI: 10.1038/nrneph.2017.95.
[10]	ISHANI A, XUE JL, HIMMELFARB J, et al. Acute kidney injury increases risk of ESRD among elderly[J]. J Am Soc Nephrol, 2009, 20(1): 223-228. DOI: 10.1681/ASN.2007080837.
[11]	LOW S, LIM SC, ZHANG X, et al. Development and validation of a predictive model for chronic kidney disease progression in type 2 diabetes mellitus based on a 13-year study in Singapore[J]. Diabetes Res Clin Pract, 2017, 123: 49-54. DOI: 10.1016/j.diabres.2016.11.008.
[12]	CHEN PM, WADA T, CHIANG CK. Prognostic value of proteinuria and glomerular filtration rate on Taiwanese patients with diabetes mellitus and advanced chronic kidney disease: A single center experience[J]. Clin Exp Nephrol, 2017, 21(2): 307-315. DOI: 10.1007/s10157-016-1290-8.
[13]	KEANE WF, ZHANG Z, LYLE PA, et al. Risk scores for predicting outcomes in patients with type 2 diabetes and nephropathy: The RENAAL study[J]. Clin J Am Soc Nephrol, 2006, 1(4): 761-767. DOI: 10.2215/CJN.01381005.
[14]	KIKUCHI H, KANDA E, MANDAI S, et al. Combination of low body mass index and serum albumin level is associated with chronic kidney disease progression: The chronic kidney disease-research of outcomes in treatment and epidemiology (CKD-ROUTE) study[J]. Clin Exp Nephrol, 2017, 21(1): 55-62. DOI: 10.1007/s10157-016-1251-2.
[15]	TRAWALÉ JM, PARADIS V, RAUTOU PE, et al. The spectrum of renal lesions in patients with cirrhosis: A clinicopathological study[J]. Liver Int, 2010, 30(5): 725-732. DOI: 10.1111/j.1478-3231.2009.02182.x.
[16]	MORINAGA J, KADOMATSU T, MIYATA K, et al. Angiopoietin-like protein 2 increases renal fibrosis by accelerating transforming growth factor-β signaling in chronic kidney disease[J]. Kidney Int, 2016, 89(2): 327-341. DOI: 10.1016/j.kint.2015.12.021.
[17]	SI J, YU C, GUO Y, et al. Chronic hepatitis B virus infection and total and cause-specific mortality: A prospective cohort study of 0.5 million people[J]. BMJ Open, 2019, 9(4): e027696. DOI: 10.1136/bmjopen-2018-027696.
[18]	SARAFIDIS PA, RUILOPE LM. Insulin resistance, hyperinsulinemia, and renal injury: Mechanisms and implications[J]. Am J Nephrol, 2006, 26(3): 232-244. DOI: 10.1159/000093632.
[19]	LAMPERTICO P, CHAN HL, JANSSEN HL, et al. Review article: Long-term safety of nucleoside and nucleotide analogues in HBV-monoinfected patients[J]. Aliment Pharmacol Ther, 2016, 44(1): 16-34. DOI: 10.1111/apt.13659.
[20]	HAGER MR, NARLA AD, TANNOCK LR. Dyslipidemia in patients with chronic kidney disease[J]. Rev Endocr Metab Disord, 2017, 18(1): 29-40. DOI: 10.1007/s11154-016-9402-z.

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Influencing factors for chronic kidney disease in patients with hepatitis B cirrhosis

DOI: 10.3969/j.issn.1001-5256.2021.08.015

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