肝脏疾病的肾脏并发症

StephenW

Renal complications of liver diseases
Johan Noble, Thomas Jouve, Paolo Malvezzi & Lionel Rostaing
Received 30 May 2018, Accepted 28 Sep 2018, Accepted author version posted online: 01 Oct 2018

    Download citation https://doi.org/10.1080/17474124.2018.1530984



Accepted author version
Abstract

Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the major causes of chronic liver disease. HBV and HCV affect nearly 7% of the world’s population. Extra-hepatic complications and particularly renal failure have different mechanisms and manifestations. The underlying mechanism, although differing for each disease, mainly involves the immune system and antibody deposits in the kidney, which can lead to tissue damage.

Areas covered: We do not cover in this review hepatorenal syndrome. We report on the renal complications of viral hepatitis (HBV, HCV, hepatitis E), autoimmune hepatitis, cirrhosis, and Wilson’s disease. The most frequent renal disorders are those related to HBV, and HCV due their high prevalence worldwide.

Expert commentary: Thanks to generalization of vaccination against HBV, prevalence of HBV-related liver diseases will decrease, and thereby its associated renal involvement such as polyarteritis nodosa (an exceptional condition), and glomerulonephritis such as membranous nephropathy. Thanks to direct acting antiviral agents HCV infection will be cured within the next decade. However, HCV-related cryoglobulinemia with or without renal involvement might evolve on its own after the patient has eliminated HCV, necessitating then rituximab therapy. Conversely, orofecal transmitted hepatitis viruses such as hepatitis A and hepatitis E are still very prevalent in developing countries; however, they are rarely associated with renal manifestations.
Keywords: kidney failure, hepatitis, glomerulonephritis, hepatitis C, hepatitis B, kidney transplantation

StephenW

肝脏疾病的肾脏并发症
Johan Noble，Thomas Jouve，Paolo Malvezzi和Lionel Rostaing
收到2018年5月30日，接受2018年9月28日，接受作者版本在线发布：2018年10月1日

    下载引文https://doi.org/10.1080/17474124.2018.1530984



接受的作者版本
抽象

简介：乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染是慢性肝病的主要原因。 HBV和HCV影响了全世界近7％的人口。肝外并发症尤其是肾功能衰竭具有不同的机制和表现。虽然每种疾病不同，但潜在的机制主要涉及肾脏中的免疫系统和抗体沉积，这可能导致组织损伤。

涵盖的领域：我们不在此审查肝肾综合征。我们报告了病毒性肝炎（HBV，HCV，戊型肝炎），自身免疫性肝炎，肝硬化和Wilson病的肾脏并发症。最常见的肾脏疾病是与HBV和HCV有关的疾病，因为它们在世界范围内流行率很高。

专家评论：由于HBV疫苗接种的普遍化，HBV相关肝病的患病率将下降，从而导致其相关的肾脏受累，如结节性多动脉炎（特殊情况）和肾小球肾炎，如膜性肾病。由于直接作用抗病毒剂，HCV感染将在未来十年内得到治愈。然而，伴有或不伴有肾脏受累的HCV相关冷球蛋白血症可能在患者消除HCV后自行发展，因此需要利妥昔单抗治疗。相反，在发展中国家，粪便传播的肝炎病毒如甲型肝炎和戊型肝炎仍然非常普遍;然而，它们很少与肾脏表现有关。