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Hepatitis C virus infection, mixed cryoglobulinemia, and kidney disease.
- Source :
-
American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2013 Apr; Vol. 61 (4), pp. 623-37. Date of Electronic Publication: 2012 Oct 25. - Publication Year :
- 2013
-
Abstract
- Hepatitis C virus (HCV) may instigate mixed cryoglobulinemia; the most significant accompanying kidney lesion is type I membranoproliferative glomerulonephritis, usually occurring in the context of type II mixed cryoglobulinemia. Additionally, recent data support a link between HCV infection and proteinuria in population-based studies, raising the possibility that kidney diseases associated with HCV may be more common than previously thought. A number of strategies have been used to treat HCV-related glomerulonephritis, including antiviral agents, immunosuppressive therapies such as corticosteroids and cytotoxic agents, and plasma exchange. Limited but encouraging data about the utility of antiviral treatment in the setting of HCV-associated glomerulonephritis exist, with one pooled analysis noting a sustained viral response of 42%, albeit with significant heterogeneity. Immunosuppressive therapy may be most useful for cryoglobulinemic kidney disease, with individualized approaches considered for the treatment of HCV-associated cryoglobulinemic glomerulonephritis based on the level of proteinuria and kidney failure. Of note, rituximab, a chimeric monoclonal antibody that blocks CD20 receptors on B cells, has been reported to be effective for the treatment of mixed cryoglobulinemia symptoms, including glomerulonephritis.<br /> (Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Cryoglobulinemia diagnosis
Cryoglobulinemia immunology
Cryoglobulinemia physiopathology
Glomerular Filtration Rate
Glomerulonephritis complications
Glomerulonephritis drug therapy
Glomerulonephritis pathology
Humans
Immunity, Cellular
Male
Vasculitis etiology
Vasculitis physiopathology
Vasculitis virology
Cryoglobulinemia complications
Cryoglobulinemia virology
Hepatitis C complications
Renal Insufficiency, Chronic complications
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6838
- Volume :
- 61
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of kidney diseases : the official journal of the National Kidney Foundation
- Publication Type :
- Academic Journal
- Accession number :
- 23102733
- Full Text :
- https://doi.org/10.1053/j.ajkd.2012.08.040