乙型肝炎病毒感染和慢性肾病的发展：一项队列研究

StephenW

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

PMID:
    30537940
DOI:
    10.1186/s12882-018-1154-4

StephenW

BMC Nephrol。 2018年12月11日; 19（1）：353。 doi：10.1186 / s12882-018-1154-4。
乙型肝炎病毒感染和慢性肾病的发展：一项队列研究。
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。
作者信息

1
    美国马里兰州巴尔的摩市约翰霍普金斯大学彭博公共卫生学院流行病学和医学系，以及韦尔奇预防，流行病学和临床研究中心。
2
    韩国首尔成均馆大学医学院Kangbuk三星医院全科医疗中心队列研究中心。
3
    韩国首尔成均馆大学三星高级健康科学与技术研究所健康科学与技术系。
4
    韩国首尔成均馆大学医学院Kangbuk三星医院职业与环境医学系。
五
    Ciccarone心脏病预防中心，约翰霍普金斯医疗机构心脏病科，美国马里兰州巴尔的摩市。
6
    Bellvitge大学医院，巴塞罗那，西班牙。
7
    RTI Health Solutions，药物流行病学和风险管理，西班牙巴塞罗那。
8
    韩国首尔医科大学成均馆大学Kangbuk三星医院检验科
9
    美国马里兰州巴尔的摩市约翰霍普金斯大学医学院医学系肾脏科。
10
    国家流行病学中心，卡洛斯三世卫生研究所和流行病学和公共卫生生物医学研究联合会（CIBERESP），西班牙马德里。
11
    韩国首尔Kangbuk三星医院和成均馆大学医学院家庭医学系。
12
    美国马里兰州巴尔的摩市约翰霍普金斯大学彭博公共卫生学院流行病学和医学系，以及韦尔奇预防，流行病学和临床研究中心。 [email protected]。
13
    韩国首尔成均馆大学医学院Kangbuk三星医院全科医疗中心队列研究中心。 [email protected]。
14
    韩国首尔成均馆大学三星高级健康科学与技术研究所健康科学与技术系。 [email protected]。
15
    美国马里兰州巴尔的摩市约翰霍普金斯大学彭博公共卫生学院流行病学和医学系，以及韦尔奇预防，流行病学和临床研究中心。 [email protected]。

抽象
背景：

慢性乙型肝炎病毒（HBV）感染对慢性肾病（CKD）风险的影响存在争议。我们检查了一大群男性和女性中乙型肝炎表面抗原（HBsAg）血清学状态与CKD事件之间的前瞻性关联。
方法：

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：

在这个大型队列中，HBsAg阳性血清学与CKD事件的高风险相关，我们提供了新的证据表明这种关联是由于HBsAg阳性参与者的蛋白尿发病率较高。我们的研究增加了越来越多的证据表明慢性HBV感染可能是CKD发病率增加的原因之一。
关键词：

慢性肾病;队列研究;乙型肝炎表面抗原;乙型肝炎病毒感染;蛋白尿;风险因素

结论：
    30537940
DOI：
    10.1186 / s12882-018-1154-4

StephenW

https://bmcnephrol.biomedcentral ... 6/s12882-018-1154-4

neilhbver

这就是乙肝引起的肾病，不知道吃着抗病毒药物能否缓解尿蛋白增高