Soderholm J, et al. - This study was performed to describe the prevalence of chronic kidney disease (CKD) and hemodialysis (HD) among patients with chronic hepatitis C (CHC) infection in the nationwide Swedish registries. CHC patients were found to be at higher risk of developing CKD. Moreover, compared with untreated CHC/HD patients, hepatitis C virus (HCV) treatment improved survival for CHC/HD patients.

Methods

• The physicians identified patients for CHC (B18.2) and CKD (N18) according to the International Classification of Diseases (ICD)-10 in the nationwide Swedish inpatient care day surgery (1997-2013) and non-primary outpatient care (2001–2013) patient registries.
• They defined HD using the procedure code in the non-primary outpatient care.
• At the time of diagnosis, up to 5 non-CHC diagnosed age/sex/place of residency-matched comparators were drawn from the general population for each patient.
• In this study, follow-up started at date of CHC diagnosis and patients accrued person-time in until death, emigration or December 31, 2013, whichever came first.

Results

• A total of 42,522 patients received a CHC diagnosis between 2001 and 2013.
• During 280,123 person-years, 2.5% patients (1,077/45,222) were diagnosed with CKD, compared with 0.7% (1,454/202,694) in the matched general population comparators (1,504,765 person-years), resulting in a standardized incidence ratio (SIR) of 4.0.
• A 3.3 to 7-time higher risk of CHC was noted in patients requiring HD.
• Seventeen percent of the CHC/HD patients were treated for CHC.
• With antiviral treatment improving survival with an odds ratio of 3.901 (P=0.001), 24% patients in the treated cohort died compared with 56% of the untreated cohort (P < 0.0001).