Liver Disease–Associated Glomerulopathies

Swetha R. Kanduri*, Yonatan Peleg, Shikha Wadhwani

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infect a significant number of individuals globally and their extra-hepatic manifestations, including glomerular disease, are well established. Additionally, liver disease–associated IgA nephropathy is the leading cause of secondary IgA nephropathy with disease course varying from asymptomatic urinary abnormalities to progressive kidney injury. Herein we provide an updated review on the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis as well as IgA nephropathy in patients with liver disease. The most common HBV-related glomerulonephritis is membranous nephropathy, although membranoproliferative glomerulonephritis and podocytopathies have been described. The best described HCV-related glomerulonephritis is cryoglobulinemic glomerulonephritis occurring in about 30% of patients with mixed cryoglobulinemic vasculitis. The mainstay of treatment for HBV-GN and HCV-GN is antiviral therapy, with significant improvement in outcomes since the emergence of the direct-acting antivirals. However, cases with severe pathology and/or a more aggressive disease trajectory can be offered a course of immunosuppression, commonly anti-CD20 therapy, particularly in the case of cryoglobulinemic glomerulonephritis.

Original languageEnglish (US)
Pages (from-to)147-156
Number of pages10
JournalAdvances in Kidney Disease and Health
Volume31
Issue number2
DOIs
StatePublished - Mar 2024

Keywords

  • Cryoglobulinemia
  • Glomerular diseases
  • Hepatitis B
  • Hepatitis C
  • Membranous nephropathy
  • Secondary IgA nephropathy

ASJC Scopus subject areas

  • Nephrology

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