TY - JOUR
T1 - Hepatitis B virus infection and development of chronic kidney disease
T2 - A cohort study
AU - Hong, Yun Soo
AU - Ryu, Seungho
AU - Chang, Yoosoo
AU - Caínzos-Achirica, Miguel
AU - Kwon, Min Jung
AU - Zhao, Di
AU - Shafi, Tariq
AU - Lazo, Mariana
AU - Pastor-Barriuso, Roberto
AU - Shin, Hocheol
AU - Cho, Juhee
AU - Guallar, Eliseo
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/12/11
Y1 - 2018/12/11
N2 - Background: The effect of chronic hepatitis B virus (HBV) infection on the risk of chronic kidney disease (CKD) is controversial. We examined the prospective association between hepatitis B surface antigen (HBsAg) serology status and incident CKD in a large cohort of men and women. Methods: Cohort study of 299,913 adults free of CKD at baseline who underwent health screening exams between January 2002 and December 2016 in South Korea. Incident CKD was defined as the development of an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 and/or proteinuria. Results: Over 1,673,701 person-years of follow-up, we observed 13,924 incident cases of CKD (3225 cases of eGFR < 60 ml/min/1.73m2 and 11,072 cases of proteinuria). In fully adjusted models comparing positive to negative HBsAg participants, the hazard ratio (HR, 95% confidence interval) for incident CKD was 1.11 (1.03-1.21; P = 0.01). The corresponding HR for incident proteinuria and for eGFR < 60 ml/min/1.73m2 were 1.23 (1.12-1.35; P < 0.001) and 0.89 (0.73-1.07; P = 0.21), respectively. The associations were similar across categories of liver enzyme levels at baseline. Conclusion: In this large cohort, HBsAg positive serology was associated with higher risk of incident CKD, and we provide novel evidence that this association was due to a higher incidence of proteinuria in HBsAg positive participants. Our study adds to the growing body of evidence suggesting that chronic HBV infection may be a contributor to the increasing incidence of CKD.
AB - Background: The effect of chronic hepatitis B virus (HBV) infection on the risk of chronic kidney disease (CKD) is controversial. We examined the prospective association between hepatitis B surface antigen (HBsAg) serology status and incident CKD in a large cohort of men and women. Methods: Cohort study of 299,913 adults free of CKD at baseline who underwent health screening exams between January 2002 and December 2016 in South Korea. Incident CKD was defined as the development of an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 and/or proteinuria. Results: Over 1,673,701 person-years of follow-up, we observed 13,924 incident cases of CKD (3225 cases of eGFR < 60 ml/min/1.73m2 and 11,072 cases of proteinuria). In fully adjusted models comparing positive to negative HBsAg participants, the hazard ratio (HR, 95% confidence interval) for incident CKD was 1.11 (1.03-1.21; P = 0.01). The corresponding HR for incident proteinuria and for eGFR < 60 ml/min/1.73m2 were 1.23 (1.12-1.35; P < 0.001) and 0.89 (0.73-1.07; P = 0.21), respectively. The associations were similar across categories of liver enzyme levels at baseline. Conclusion: In this large cohort, HBsAg positive serology was associated with higher risk of incident CKD, and we provide novel evidence that this association was due to a higher incidence of proteinuria in HBsAg positive participants. Our study adds to the growing body of evidence suggesting that chronic HBV infection may be a contributor to the increasing incidence of CKD.
KW - Chronic kidney disease
KW - Cohort study
KW - Hepatitis B surface antigen
KW - Hepatitis B virus infection
KW - Proteinuria
KW - Risk factors
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U2 - 10.1186/s12882-018-1154-4
DO - 10.1186/s12882-018-1154-4
M3 - Article
C2 - 30537940
AN - SCOPUS:85058284032
SN - 1471-2369
VL - 19
JO - BMC nephrology
JF - BMC nephrology
IS - 1
M1 - 353
ER -