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KMID : 0191120180330420264
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Journal of Korean Medical Science
2018 Volume.33 No. 42 p.264 ~ p.264
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Chronic Hepatitis B Infection Is Significantly Associated with Chronic Kidney Disease: a Population-based, Matched Case-control Study
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Kim Sung-Eun
Jang Eun-Sun
Ki Mo-Ran
Gwak Geum-Youn
Kim Kyung-Ah
Kim Gi-Ae
Kim Do-Young
Kim Dong-Joon
Kim Man-Woo
Kim Yun-Soo
Kim Young-Seok
Kim In-Hee
Kim Chang-Wook
Kim Ho-Dong
Kim Hyung-Joon
Park Neung-Hwa
Baik Soon-Koo
Suh Jeong-Ill
Song Byung-Cheol
Song Il-Han
Yeon Jong-Eun
Lee Byung-Seok
Lee Youn-Jae
Jung Young-Kul
Chung Woo-Jin
Cho Sung-Bum
Cho Eun-Young
Cho Hyun-Chin
Cheon Gab-Jin
Chae Hee-Bok
Choi Dae-Hee
Choi Sung-Kyu
Choi Hwa-Young
Tak Won-Young
Heo Jeong
Jeong Sook-Hyang
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Abstract
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Background: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study.
Methods: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 or proteinuria as at least grade 2+ of urine protein.
Results: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m2 (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m2 along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m2.
Conclusion: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m2 and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
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KEYWORD
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Hepatitis B Virus, Chronic Renal Insufficiency, Glomerular Filtration Rate, Proteinuria
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