BMC Nephrol. 2018 Dec 11;19(1):353. doi: 10.1186/s12882-018-1154-4.
Hepatitis B virus infection and development of chronic kidney disease: a cohort study.
Hong YS1, Ryu S2,3,4, Chang Y2,3,4, Caínzos-Achirica M1,5,6,7, Kwon MJ2,8, Zhao D1, Shafi T1,9, Lazo M1, Pastor-Barriuso R10, Shin H11, Cho J12,13,14, Guallar E15.
Author information
1
Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
2
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Department of Health Sciences and Technology, Samsung Advanced Institute for Health, Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
4
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5
Ciccarone Center for the Prevention of Heart Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
6
Bellvitge University Hospital, Barcelona, Spain.
7
RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain.
8
Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
9
Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
10
National Center for Epidemiology, Carlos III Institute of Health and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
11
Department of Family Medicine, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
12
Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
13
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. [email protected].
14
Department of Health Sciences and Technology, Samsung Advanced Institute for Health, Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea. [email protected].
15
Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
Abstract
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.
KEYWORDS:
Chronic kidney disease; Cohort study; Hepatitis B surface antigen; Hepatitis B virus infection; Proteinuria; Risk factors
2002年1月至2016年12月在韩国接受健康检查检查的299,913名基线CKD成人的队列研究。事件CKD定义为估计的肾小球滤过率（eGFR）<60ml / min / 1.73m2和/或蛋白尿的发展。
结果：
随访超过1,673,701人年，我们观察到13,924例CKD事件（3225例eGFR <60 ml / min / 1.73m2和11,072例蛋白尿）。在比较阳性和阴性HBsAg参与者的完全调整模型中，事件CKD的风险比（HR，95％置信区间）为1.11（1.03-1.21; P = 0.01）。发生蛋白尿和eGFR <60 ml / min / 1.73m2的相应HR分别为1.23（1.12-1.35; P <0.001）和0.89（0.73-1.07; P = 0.21）。在基线时，各种肝酶水平的相关性相似。
结论：