TY - JOUR
T1 - Liver Disease–Associated Glomerulopathies
AU - Kanduri, Swetha R.
AU - Peleg, Yonatan
AU - Wadhwani, Shikha
N1 - Publisher Copyright:
© 2023 National Kidney Foundation, Inc.
PY - 2024/3
Y1 - 2024/3
N2 - 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.
AB - 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.
KW - Cryoglobulinemia
KW - Glomerular diseases
KW - Hepatitis B
KW - Hepatitis C
KW - Membranous nephropathy
KW - Secondary IgA nephropathy
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UR - http://www.scopus.com/inward/citedby.url?scp=85190772632&partnerID=8YFLogxK
U2 - 10.1053/j.akdh.2023.11.002
DO - 10.1053/j.akdh.2023.11.002
M3 - Review article
C2 - 38649219
AN - SCOPUS:85190772632
SN - 2949-8139
VL - 31
SP - 147
EP - 156
JO - Advances in Kidney Disease and Health
JF - Advances in Kidney Disease and Health
IS - 2
ER -