Positive HBV serology tied to modest increase in CKD risk

  • BMC Nephrol
  • 11 Dec 2018

  • curated by Yael Waknine
  • Clinical Essentials
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Takeaway

  • Positive HBV surface antigen (HBsAg+) serology is associated with a modest increased risk for chronic kidney disease (CKD), according to data from a large population study.

Why this matters

  • Prior evidence of the association is conflicting; 1 large Taiwanese study found much higher risk for incident CKD (HR=2.58) and end-stage renal disease (ESRD) (HR=3.85) but was limited by use of ICD codes.

Study design

  • Korean study of 299,913 adults (mean age, 37.3±7.9 years); 3.7% (n=11,209) were HBsAg+.
  • CKD defined as estimated glomerular filtration rate (eGFR, in mL/minute/1.72 m2)
  • Funding: None.   

Key results

  • Mean follow-up, 5.6 years (1,673,701 person-years [PY]).
  • 13,924 incident cases of CKD reported (incidence rate, 8.3/1000 PY).
    • eGFR
    • Proteinuria: 11,072 cases (incidence rate, 6.6/1000 PY).
  • CKD incidence rate was higher in HBsAg+ vs HBsAg patients (9.3 vs 8.3/1000 PY).
  • HBsAg+ serology was tied to an 11% increased risk for incident CKD (HR=1.11; P=.01).
    • Effect driven by proteinuria (HR=1.23; P<.001 not egfr>
  • Results were consistent after excluding patients treated for viral hepatitis, and in sensitivity analysis excluding those with liver cirrhosis or HCV+ serology.

Limitations

  • Proteinuria detected by dipstick test.
  • Limited follow-up (young population).
  • Viral load, use of nephrotoxic agents not captured.