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J Korean Med Sci. 2018 Sep 12;33(42):e264. doi: 10.3346/jkms.2018.33.e264. eCollection 2018 Oct 15.

Chronic Hepatitis B Infection Is Significantly Associated with Chronic Kidney Disease: a Population-based, Matched Case-control Study.

Author information

1
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
2
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
3
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
4
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
5
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
6
Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
7
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
8
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
9
Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea.
10
Department of Internal Medicine, Gachon University, College of Medicine, Incheon, Korea.
11
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
12
Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju, Korea.
13
Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea.
14
Department of Internal Medicine, St. Carollo General Hospital, Suncheon, Korea.
15
Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
16
Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan, Korea.
17
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
18
Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.
19
Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea.
20
Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
21
Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
22
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
23
Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
24
Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
25
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
26
Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
27
Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea.
28
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.
29
Department of Internal Medicine, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
30
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
31
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
32
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
33
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
34
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

Abstract

Background:

Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study.

Methods:

A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 or proteinuria as at least grade 2+ of urine protein.

Results:

HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m2 (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m2 along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m2.

Conclusion:

Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m2 and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.

KEYWORDS:

Chronic Renal Insufficiency; Glomerular Filtration Rate; Hepatitis B Virus; Proteinuria

PMID:
30310365
PMCID:
PMC6179986
DOI:
10.3346/jkms.2018.33.e264
[Indexed for MEDLINE]
Free PMC Article

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