Brief communication: Glomerulonephritis in patients with hepatitis C cirrhosis undergoing liver transplantation
Brief communication: Glomerulonephritis in patients with hepatitis C cirrhosis undergoing liver transplantation
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DOI：
10.7326/0003-4819-144-10-200605160-00007
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发表时间：
2006-05-16
影响因子：
39.2
通讯作者：
Eckhoff, Devin E.
中科院分区：
文献类型：
--
作者：
McGuire, Brendan M.;Julian, Bruce A.;Eckhoff, Devin E.
背景资料：丙型肝炎病毒（HCV）感染的患者在肝移植后经常发生肾功能衰竭。目的：描述HCV感染的终末期肝硬化患者的肾脏组织学特征和伴随的临床特征。设计：病例系列。设置：美国单中心肝移植计划。患者：30例因HCV诱导的肝硬化接受肝移植的患者。干预：肝移植术前6个月内肾功能的临床资料和实验室检查。结果：25例患者有免疫复合物肾小球肾炎：膜增生性肾小球肾炎1型（n = 12），伊加肾病（n = 7），和系膜肾小球肾炎（n = 6）。在这些患者中，10例血清肌酐水平正常，尿分析结果正常，尿蛋白定量正常。对于其他5例患者，唯一的肾脏异常是血清肌酐水平升高。没有病人在血液或kidney.Limitations：这个小的观察性研究不包括非病毒性肝硬化患者，并没有记录移植后outcomes.Conclusions：免疫复合物肾小球肾炎是常见的终末期HCV引起的肝硬化患者，往往是临床沉默。其在肝移植后引起肾衰竭的可能性可能被低估。
Background: Patients infected with hepatitis C virus (HCV) frequently develop renal failure after liver transplantation.Objective: To describe renal histologic characteristics and concomitant clinical features in HCV-infected patients with end-stage cirrhosis.Design: Case series.Setting: Single-center liver transplant program in the United States.Patients: 30 patients who received liver transplants for HCV-induced cirrhosis.Intervention: Kidney biopsy during liver engraftment.Measurements: Clinical data and laboratory tests of renal function within 6 months before liver transplantation.Results: Twenty-five patients had immune-complex glomerulonephritis: membranoproliferative glomerulonephritis type 1 (n = 12), IgA nelphropathy (n = 7), and mesangial glomerulonephritis (n 6). Of these patients, 10 had normal serum creatinine levels, normal urinalysis results, and normal quantitative proteinuria. For 5 others, the only renal abnormality was an increased serum creatinine level. No patient had cryoglobulins in the blood or kidney.Limitations: This small observational study did not include patients with nonviral cirrhosis and did not document post-transplantation outcomes.Conclusions: immune-complex glomerulonephritis was common in patients with end-stage HCV-induced cirrhosis and was often clinically silent. Its potential to cause renal failure after liver transplantation may be underappreciated.