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13-year nationwide cohort study of chronic kidney disease risk among treatment-naïve patients with chronic hepatitis B in Taiwan.

Chen YC, Su YC, Li CY, Hung SK - BMC Nephrol (2015)

Bottom Line: The risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % confidence interval [CI], 5.4-7.1 %) than in the non-HBV cohort (2.7 %; 95 % CI, 2.5-3.0 %) (p < 0.001), and the aHR was 2.58 (95 % CI, 1.95-3.42; p < 0.001).Multivariable stratified analysis further verified significant associations of CKD with HBV in men of any age (aHR, 2.98; 95 % CI, 2.32-3.83, p < 0.001 for men aged <50 years; aHR, 1.58; 95 % CI, 1.31-1.91, p < 0.001 for men aged ≧ 50 years) and women under the age of 50 (aHR, 2.99; 95 % CI, 2.04-4.42, p < 0.001), but no significant association in women aged 50 or over.Hence, high-risk HBV-infected subjects should have targeted monitoring for the development of CKD.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, No. 2, Minsheng Rd., Dalin Township, Chiayi, County 622, Taiwan. chenyichun0320@yahoo.com.tw.

ABSTRACT

Background: Chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD) have high prevalences in Taiwan and worldwide. However, the association of untreated chronic hepatitis B virus (HBV) infection with chronic kidney disease (CKD) remains unclear.

Methods: This cohort study used claims data in the Taiwan National Health Insurance Research Database in 1996-2010, in which all diseases were classified by ICD-9-CM codes. We identified 17796 adults who had chronic HBV infection and did not take nucleos(t)ide analogues from 1998 to 2010 and also randomly selected 71184 matched controls without HBV in the same dataset. Cumulative incidences and adjusted hazard ratio (aHR) of incident CKD were evaluated through the end of 2010 after adjusting for competing mortality.

Results: The risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % confidence interval [CI], 5.4-7.1 %) than in the non-HBV cohort (2.7 %; 95 % CI, 2.5-3.0 %) (p < 0.001), and the aHR was 2.58 (95 % CI, 1.95-3.42; p < 0.001). Multivariable stratified analysis further verified significant associations of CKD with HBV in men of any age (aHR, 2.98; 95 % CI, 2.32-3.83, p < 0.001 for men aged <50 years; aHR, 1.58; 95 % CI, 1.31-1.91, p < 0.001 for men aged ≧ 50 years) and women under the age of 50 (aHR, 2.99; 95 % CI, 2.04-4.42, p < 0.001), but no significant association in women aged 50 or over.

Conclusion: Untreated chronic HBV infection is associated with increased risk of CKD. Hence, high-risk HBV-infected subjects should have targeted monitoring for the development of CKD.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of CKD in the HBV and non-HBV cohorts. Data were compiled after adjustment for competing mortality
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Fig1: Cumulative incidence of CKD in the HBV and non-HBV cohorts. Data were compiled after adjustment for competing mortality

Mentions: The 1-, 3-, 5-, 7-, 9-, 11-, and 13-year cumulative incidences of CKD were 0.26 % vs. 0.10 %, 0.77 % vs. 0.33 %, 1.35 % vs. 0.65 %, 2.00 % vs. 1.00 %, 2.90 % vs. 1.48 %, 4.30 % vs. 2.12 %, and 6.20 % vs. 2.74 %, respectively, in the HBV cohort compared with the control cohort (all p < 0.001, Table 2). Therefore, the risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % CI, 5.4–7.1 %) than the control cohort (2.7 %; 95 % CI, 2.5–3.0 %) (p < 0.001, Fig. 1).Table 2


13-year nationwide cohort study of chronic kidney disease risk among treatment-naïve patients with chronic hepatitis B in Taiwan.

Chen YC, Su YC, Li CY, Hung SK - BMC Nephrol (2015)

Cumulative incidence of CKD in the HBV and non-HBV cohorts. Data were compiled after adjustment for competing mortality
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4508999&req=5

Fig1: Cumulative incidence of CKD in the HBV and non-HBV cohorts. Data were compiled after adjustment for competing mortality
Mentions: The 1-, 3-, 5-, 7-, 9-, 11-, and 13-year cumulative incidences of CKD were 0.26 % vs. 0.10 %, 0.77 % vs. 0.33 %, 1.35 % vs. 0.65 %, 2.00 % vs. 1.00 %, 2.90 % vs. 1.48 %, 4.30 % vs. 2.12 %, and 6.20 % vs. 2.74 %, respectively, in the HBV cohort compared with the control cohort (all p < 0.001, Table 2). Therefore, the risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % CI, 5.4–7.1 %) than the control cohort (2.7 %; 95 % CI, 2.5–3.0 %) (p < 0.001, Fig. 1).Table 2

Bottom Line: The risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % confidence interval [CI], 5.4-7.1 %) than in the non-HBV cohort (2.7 %; 95 % CI, 2.5-3.0 %) (p < 0.001), and the aHR was 2.58 (95 % CI, 1.95-3.42; p < 0.001).Multivariable stratified analysis further verified significant associations of CKD with HBV in men of any age (aHR, 2.98; 95 % CI, 2.32-3.83, p < 0.001 for men aged <50 years; aHR, 1.58; 95 % CI, 1.31-1.91, p < 0.001 for men aged ≧ 50 years) and women under the age of 50 (aHR, 2.99; 95 % CI, 2.04-4.42, p < 0.001), but no significant association in women aged 50 or over.Hence, high-risk HBV-infected subjects should have targeted monitoring for the development of CKD.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, No. 2, Minsheng Rd., Dalin Township, Chiayi, County 622, Taiwan. chenyichun0320@yahoo.com.tw.

ABSTRACT

Background: Chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD) have high prevalences in Taiwan and worldwide. However, the association of untreated chronic hepatitis B virus (HBV) infection with chronic kidney disease (CKD) remains unclear.

Methods: This cohort study used claims data in the Taiwan National Health Insurance Research Database in 1996-2010, in which all diseases were classified by ICD-9-CM codes. We identified 17796 adults who had chronic HBV infection and did not take nucleos(t)ide analogues from 1998 to 2010 and also randomly selected 71184 matched controls without HBV in the same dataset. Cumulative incidences and adjusted hazard ratio (aHR) of incident CKD were evaluated through the end of 2010 after adjusting for competing mortality.

Results: The risk of CKD was significantly higher in the HBV cohort (13-year cumulative incidence, 6.2 %; 95 % confidence interval [CI], 5.4-7.1 %) than in the non-HBV cohort (2.7 %; 95 % CI, 2.5-3.0 %) (p < 0.001), and the aHR was 2.58 (95 % CI, 1.95-3.42; p < 0.001). Multivariable stratified analysis further verified significant associations of CKD with HBV in men of any age (aHR, 2.98; 95 % CI, 2.32-3.83, p < 0.001 for men aged <50 years; aHR, 1.58; 95 % CI, 1.31-1.91, p < 0.001 for men aged ≧ 50 years) and women under the age of 50 (aHR, 2.99; 95 % CI, 2.04-4.42, p < 0.001), but no significant association in women aged 50 or over.

Conclusion: Untreated chronic HBV infection is associated with increased risk of CKD. Hence, high-risk HBV-infected subjects should have targeted monitoring for the development of CKD.

No MeSH data available.


Related in: MedlinePlus