Clin J Am Soc Nephrol. 2012 Aug 2. [Epub ahead of print]
Association of Reduced Renal Function with Hepatitis B Virus Infection and Elevated Alanine Aminotransferase.
Cai J, Fan X, Mou L, Gao B, Liu X, Li J, Liu L, Wang H, Guo Z, Liu X, Li H, Li X, Li X.
Source
Departments of Nephrology and, §Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China;, †Clinical Epidemiology Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, ‡Department of Nephrology, Pinggu Hospital of Beijing, Beijing, China.
Abstract
BACKGROUND AND OBJECTIVES:
Clinically, hepatitis B virus (HBV) infection is observed to be associated with nephropathy. However, previous population-based studies failed to show an association between HBV infection and CKD. Therefore, this cross-sectional study was designed to further explore this association.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:
A representative sample of 6854 Chinese adults aged 30-75 years was tested for levels of serum hepatitis B surface antigen, alanine aminotransferase (ALT), creatinine, urinary albumin/creatinine ratio, and potential CKD risk factors.
RESULTS:
Neither HBV infection nor elevated ALT (ALT+; ≥ sex-specific 90th percentile of ALT levels of noninfected persons) was significantly associated with reduced estimated GFR (eGFR < 60 ml/min per 1.73 m(2)). Compared with noninfected persons, HBV-infected persons with ALT+, but not those with ALT- (P=0.26), were more likely to have reduced eGFR (odds ratio, 4.07; 95% confidence interval, 1.18-14.0; P=0.03). Further analysis with a general linear model revealed a significant difference in eGFR (mean ± SEM) between HBV-infected and noninfected persons (87.8±0.8 versus 90.2±0.4 ml/min per 1.73 m(2); P=0.002). This difference was mainly derived from that between HBV-infected persons with ALT+ and noninfected persons, with an average difference in eGFR of -4.5 (95% confidence interval, -0.9 to -8.1; P=0.01). HBV infection and ALT+, alone or in combination, were not significantly associated with albuminuria or CKD.
CONCLUSIONS:
HBV infection with elevated ALT, rather than HBV infection alone, was associated with reduced renal function.
临床研究SOC Nephrol。 2012年8月2日。 [EPUB的提前打印]
协会与B型肝炎病毒感染与谷丙转氨酶升高,肾功能减退。
范X,J,蔡谋高B,L,王华,刘李江,刘X,L,郭正堂,刘,李瀚,李新,李新
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