Association of Hepatitis C Virus Infection with Risk of ESRD: a Population-based Study

Background: The association between chronic hepatitis C virus (HCV) infection and end-stage renal disease (ESRD) has been widely debated.

Study Design: National population-based cohort study.

Setting & Participants: Insurance claims data from the Taiwan National Health Insurance Research Database in 2000-2005.

Predictor: Chronic HCV infection as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification.

Outcomes: ESRD as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification.

Results: We identified 6,291 adults with chronic HCV infection. The control group included 31,455 sex- and age-matched individuals without evidence of chronic hepatitis. The incidence of ESRD was 2.14-fold higher in patients with chronic HCV infection (HR, 1.53; 95% CI, 1.17-2.01; P = 0.002) than in patients without HCV infection. Age stratification analysis showed that patients aged 50-59 years with chronic HCV infection (HR, 7.77; 95% CI, 4.23-14.3; P < 0.001) had the highest risk of developing ESRD relative to patients aged 20-49 years without chronic HCV infection (interaction P < 0.001).

Limitations: Lack of clinical data.

Conclusions: Patients with chronic HCV infection are at greater risk of developing ESRD than individuals without chronic HCV infection. In addition, the risk of developing ESRD is highest in younger patients with HCV infection. Early renal screening programs should be initiated for this high-risk group of young individuals with chronic HCV infection.