Avtor/Urednik		Luzar, Boštjan; Ferlan-Marolt, Vera; Brinovec, Vladimir; Lešničar, Gorazd; Klopčič, Ulrika; Poljak, Mario
Naslov		Does end stage kidney failure influence hepatitis C progression in haemodialysis patients?
Tip		članek
Vir		Hepatogastroenterology
Vol. in št.		Letnik 50, št. 49
Leto izdaje		2003
Obseg		str. 157-60
Jezik		eng
Abstrakt		The influence of end stage kidney failure on the progression of liver disease in patients infected with hepatitis C virus (HCV) and treated with haemodialysis (HD) is still controversial. To further address this question, liver histology of 154 HCV infected nonuraemic patients was compared with liver histology of 13 HCV infected uraemic patients treated with HD due to the end stage kidney disease. Pathohistological grading of necroinflammatory activity so as staging of architectural changes in the liver was determined according to the criteria proposed by International Group of Experts. Statistical analysis for each separate grading as well as staging component was performed by using a nonparametrical Wilcoxon signed rank test. In either group of altogether 167 patients, no normal liver histology was found. Each patient had at least a low-grade lobular and/or portal inflammation. However, statistically significant differences were observed between HCV infected uraemic and non-uraemic patients in the extent of intralobular changes (p=0.043), portal inflammation (p=0.043), and degree of fibrosis (p=0.017). In conclusion, non-uraemic HCV infected patients appear to have more activiti and progressive liver disease than HCV infected patients on HD. Regular follow-up of uraemic patients, associated with earlier detection of HCV infection, so as suggested uraemia-associated impaired immunoreactivity and increased levels of hepatocyte growth factor described recently, might be implicated in a more favourable course of HCV infection in uraemic patients. In addition, due to the absence of normal liver histology in either group of HCV infected patients, we propose liver biopsy to be mandatory in all these patients, provided that no contraindications exist clinically.
Deskriptorji		KIDNEY FAILURE, CHRONIC HEPATITIS C DISEASE PROGRESSION HEMODIALYSIS LIVER RISK FACTORS SEVERITY OF ILLNESS INDEX VIRAL LOAD