Nephrology (Carlton, Vic.)最新文献

{"title":"Treatment preferences for primary membranous nephropathy: Results of a multinational survey among nephrologists in the South Asia Pacific region.","authors":"Bhadran Bose,&nbsp;Sunil V Badve,&nbsp;David W Johnson,&nbsp;Carmel Hawley,&nbsp;Vivekanand Jha,&nbsp;Donna Reidlinger,&nbsp;Chen Au Peh","doi":"10.1111/nep.13953","DOIUrl":"https://doi.org/10.1111/nep.13953","url":null,"abstract":"<p><strong>Aim: </strong>There is no clear consensus on how best to treat primary membranous nephropathy (PMN). This study aimed to ascertain prevailing views among nephrologists on their choice of immunosuppressive agents to treat this disease.</p><p><strong>Methods: </strong>The Australasian Kidney Trials Network conducted a multinational online survey among nephrologists from the South Asia-Pacific region to identify prescribing practices to treat PMN. Survey questions focused on the types of immunosuppressive therapies used, preferred first-line and second-line therapies, indications for starting immunosuppressive therapy, the preferred mode of combining corticosteroid and cyclophosphamide, the use of serum phospholipase A2 receptor antibody testing in clinical practice, indications for anticoagulation, and interest in participating in future clinical trials in PMN.</p><p><strong>Results: </strong>One hundered fifty-five nephrologists from eight countries responded to the online survey. The majority of them were senior nephrologists from Australia and India with significant experience managing patients with PMN. The combination of cyclophosphamide and corticosteroid was the preferred first-line therapy. Of those who used this combination, only 34.8% followed the Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines by adding intravenous methylprednisolone. The combination of calcineurin inhibitor with corticosteroid was the most common second-line therapy. Most respondents considered prophylactic anticoagulation if serum albumin was less than 25 g/L. Most nephrologists were keen to participate in a clinical trial with a control arm consisting of cyclophosphamide and corticosteroids.</p><p><strong>Conclusion: </strong>The combination of corticosteroid with cyclophosphamide (without intravenous methylprednisolone) is the most commonly reported first-line immunosuppressive therapy for the management of PMN.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"35-43"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39310704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of galectin-3 in peritoneal dialysate. Does it have a role in the peritoneal membrane inflammatory process?","authors":"Yael Einbinder,&nbsp;Ayala Siboni,&nbsp;Shirley Zaidenstein,&nbsp;Keren Cohen-Hagai,&nbsp;Sydney Benchetrit,&nbsp;Tali Zitman-Gal","doi":"10.1111/nep.13981","DOIUrl":"https://doi.org/10.1111/nep.13981","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) causes structural and functional changes in the peritoneal membrane, which are attributed to local inflammatory process. This study assessed the presence of galectin-3 (Gal-3), a known inflammatory modulator, in dialysate effluent and correlated its levels with markers of inflammatory process. Gal-3 levels in serum and dialysate effluent were measured in prevalent PD patients on morning visits (n = 27) or during peritoneal equilibration tests (PET, n = 16), it association with clinical and laboratory parameters, including dialysate/plasma creatinine (D/P creatinine) and interleukin-6 (IL-6) levels was analysed. Gal-3 levels in dialysate effluent correlated with D/P creatinine (0.663, p = 0.005) and dialysate effluent IL-6 levels (0.674, p = 0.002), but not with serum Gal-3 levels or dialysis vintage. Patients who were high transporters had higher Gal-3 levels in dialysate effluent, as compared to lower transporters. In multivariate regression analysis, dialysate IL-6 level was the strongest predictor of dialysate Gal-3 levels. This study found Gal-3 in dialysate effluent correlated with D/P creatinine and dialysate IL-6 levels. These findings may imply that Gal-3 has a role in the intraperitoneal inflammatory process. However, this needs to be investigated further.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"104-108"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39488303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of body mass index with kidney function and mortality in high cardiovascular risk population: A nationwide prospective cohort study.","authors":"Noppawit Aiumtrakul,&nbsp;Annop Kittithaworn,&nbsp;Ouppatham Supasyndh,&nbsp;Rungroj Krittayaphong,&nbsp;Arintaya Phrommintikul,&nbsp;Bancha Satirapoj","doi":"10.1111/nep.13970","DOIUrl":"https://doi.org/10.1111/nep.13970","url":null,"abstract":"<p><strong>Background: </strong>There is increasing awareness of the impact of obesity and underweight on cardiovascular (CV) disease, chronic kidney disease (CKD) and mortality. Abnormal body mass index (BMI) might be associated with worse clinical outcomes, including CKD progression, but limited evidence exists among Asian patients with high CV risk.</p><p><strong>Objective: </strong>To investigate the association of BMI with progressive loss of kidney function and all-cause mortality in Thai patients with high CV risk.</p><p><strong>Methods: </strong>In a national cohort of 5887 high CV risk subjects, we assessed the association of high BMI with the composite renal outcome (estimated glomerular filtration rate [eGFR] decline over 40%, eGFR less than 15 mL/min/1.73 m² , doubling of serum creatinine, initiation of dialysis and death related to renal causes) and with all-cause mortality in Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 5887 participants (3217 male and 2670 female) with high CV risk were enrolled. Participants were classified into five groups by their baseline BMI; <20 kg/m² (n = 482), 20-24.9 kg/m² (n = 2437), 25-29.9 kg/m² (n = 2140), 30-34.9 kg/m² (n = 665) and 35 kg/m² (n = 163), respectively. On multivariate analysis of Cox proportional hazards models, adjusted for other covariates, baseline BMI ≥35 kg/m² was an independent predictor of loss of kidney function (HR 1.60, 95% CI 1.04-2.40) and all-cause mortality (HR 2.68, 95% CI 1.50-4.80). Baseline BMI <20 kg/m² was an independent predictor of all-cause mortality as well (adjusted HR 2.26, 95% CI 1.50-3.42).</p><p><strong>Conclusion: </strong>In the high CV risk Thai population, a BMI of 35 kg/m² or more is associated with loss of kidney function and mortality. On the other hand, a BMI less than 20 kg/m² is also associated with all-cause mortality.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"25-34"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13970","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39372015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta-analysis.","authors":"Yung Lee,&nbsp;Sama Anvari,&nbsp;Megan M Chu,&nbsp;Olivia Lovrics,&nbsp;Adree Khondker,&nbsp;Roshan Malhan,&nbsp;Ishan Aditya,&nbsp;Aristithes G Doumouras,&nbsp;Michael Walsh,&nbsp;Dennis Hong","doi":"10.1111/nep.13958","DOIUrl":"https://doi.org/10.1111/nep.13958","url":null,"abstract":"<p><p>The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta-analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle-Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I²  = 66%) ml/min/1.73m² and reduced SCr with MD of -0.24 (95%CI -0.21 to -0.39, I²  = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of -1.13 (95%CI: -0.83 to -2.07, I²  = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of -3.03 (95%CI: -1.44 to -6.40, I²  = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"44-56"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39297565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De novo and relapsing glomerulonephritis after COVID-19 vaccination: how much do we know?","authors":"Anthony T P Chan,&nbsp;Sydney C W Tang","doi":"10.1111/nep.14013","DOIUrl":"https://doi.org/10.1111/nep.14013","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is one of the deadliest viral pandemic in human history. To date, over 267 million people have been infected with a death toll of over 5.2 million around the world. To curb the spread of this infection, over 8.2 billion doses of COVID19 vaccine have been administered so far. While vaccine efficacy has become palpable in many countries with a high vaccination rate, there is mounting concern on the increasing incidence of vaccineassociated adverse events. De novo onset of glomerulonephritis (GN) after influenza, hepatitis B, and rabies immunization was previously reported, including minimal change disease (MCD), membranous nephropathy, IgA nephropathy (IgAN) and ANCA-associated vasculitis with variable severity and outcomes. With the ongoing massive vaccination programme worldwide, it is not surprising that reports of de novo GN after COVID-19 vaccination emerged. Clinicians often lack of data to advise patients about the chance of relapse of GN after COVID19 vaccination and the current recommendation was based on case reports and clinical experience. In this issue of Nephrology, three case series are published with denovo or relapse of different glomerulonephritides after COVID-19 mRNA vaccination. Lo et al from Hong Kong reported two IgAN patients who developed gross haematuria within hours of receiving the BNT162b2 COVID-19 vaccine. Kidney function was preserved in both patients and there was no significant change in the level of proteinuria. Haematuria was the most common symptom in other case series and significant acute kidney injury (AKI) that requires dialysis support is uncommon. As a mucosal IgA response is known to trigger haematuria in IgAN, it remains unclear whether the vaccine could have stimulated muscosal immunity. However, IgAN is more common in the Asian population, and the frequency and severity of vaccineassociated GN flare may be different from other ethnic groups. This is exemplified by the markedly different prevalence of AKI among COVID-19 patients. More data from different ethnic populations may help to inform the frequency, severity and risk of relapse of IgAN after immunization. From Australia, Baskaran et al reported two cases of de novo MCD following COVID-19 vaccination. The first case developed MCD disease 3 weeks after receiving the BNT162b2 mRNA COVID-19 vaccine. The patient responded well to high-dose corticosteroid. The other case was a middle-aged man with ascites and peripheral oedema 1 week after the second dose of the ChAdOx1 nCoV-19 vaccine when he took non-steroidal anti-inflammatory drug (NSAID). The clinical course was complicated by oliguric AKI and subsequent kidney biopsy showed acute tubulointerstitial nephritis (ATIN) and MCD. Proteinuria and AKI were both ameliorated after high-dose corticosteroid. Although the authors believed NSAID was the culprit, the association of ATIN with COVID-19 vaccine cannot be fully excluded. ATIN after COVID-19 vaccination was reporte","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"5-6"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39857814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relapsed ANCA associated vasculitis following Oxford AstraZeneca ChAdOx1-S COVID-19 vaccination: A case series of two patients.","authors":"Rachel David,&nbsp;Paul Hanna,&nbsp;Kenneth Lee,&nbsp;Angus Ritchie","doi":"10.1111/nep.13993","DOIUrl":"https://doi.org/10.1111/nep.13993","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"109-110"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646290/pdf/NEP-27-109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic acidosis in the initial 6 months after renal transplantation: A prospective study.","authors":"Kristin George,&nbsp;Ashish Datt Upadhyay,&nbsp;Arun Kumar Subbiah,&nbsp;Raj Kanwar Yadav,&nbsp;Sandeep Mahajan,&nbsp;Dipankar Bhowmik,&nbsp;Sanjay Kumar Agarwal,&nbsp;Soumita Bagchi","doi":"10.1111/nep.13954","DOIUrl":"https://doi.org/10.1111/nep.13954","url":null,"abstract":"<p><strong>Background: </strong>There is limited information about the incidence of metabolic acidosis (MA) after renal transplantation. This single centre prospective study aimed to delineate the incidence and risk factors of MA in the first 6 months after renal transplantation (RTX).</p><p><strong>Design, setting, participants and measurements: </strong>Patients who underwent RTX between November 2018 and July 2020 were monitored with weekly measurement of serum bicarbonate level for 6 months and those who were diagnosed with MA were evaluated further to characterize the type of MA.</p><p><strong>Results: </strong>One hundred and twenty-five patients were included in the study, 89 (71.2%) of whom developed MA. Seventy-two patients developed MA in the first month, 11 during the 2-3 months and 6 between 4 and 6 months after transplantation. Of the 89 patients, 55(61.8%) had type 1 renal tubular acidosis (T1RTA), 27 (30.3%) had type 2 RTA (T2RTA) and 7 (7.9%) type 4 RTA (T4RTA). Two patient who had T1RTA, subsequently developed high anion gap MA following severe graft rejection. On stepwise multivariate regression analysis, serum creatinine at time of diagnosis of MA [OR (95% CI): 12.02 (1.79 to 80.59), p = .01] and high tacrolimus C0 levels [OR (95% CI): 2.43 (1.0 to 5.90), p = .049], were independent risk factors for MA.</p><p><strong>Conclusion: </strong>There is a high incidence of MA in the initial 6 months post-transplant with serum creatinine and high tacrolimus C0 levels being independent risk factors.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"90-96"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39221150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic and systolic left ventricular dysfunction and mortality in chronic kidney disease patients on haemodialysis.","authors":"Jose J G De Lima,&nbsp;Thiago A Macedo,&nbsp;Luis Henrique W Gowdak,&nbsp;Elias David-Neto,&nbsp;Luiz A Bortolotto","doi":"10.1111/nep.13960","DOIUrl":"https://doi.org/10.1111/nep.13960","url":null,"abstract":"<p><strong>Aims: </strong>Left ventricular diastolic dysfunction (LVDD) and LV systolic dysfunction (LVSD) are prevalent in CKD, but their prognostic relevance is debatable. We intent to verify whether LVDD and LVSD are independently predictive of all-cause mortality and if they have comparable or different effects on outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of the echocardiographic data of 1285 haemodialysis patients followed up until death or transplantation. LVDD was classified into 4 grades of severity. Endpoint was all-cause mortality.</p><p><strong>Results: </strong>During a follow-up of 30 months, 419/1285 (33%) patients died, 224 (53%) due to CV events. LVDD occurred in 75% of patients, grade 1 DD was the prevalent diastolic abnormality, and pseudonormal pattern was the predominant form of moderate-severe DD. Moderate-severe LVDD (HR 1.379, CI% 1.074-1.770) and LVSD (HR 1.814, CI% 1.265-2.576) independently predicted death; a graded, progressive association was found between LVDD categories and the risk of death; and the impact of isolated severe-moderate LVDD on the risk of death was comparable to that exercised by isolated compromised LV systolic function.</p><p><strong>Conclusion: </strong>Moderate-severe LVDD and LVSD were independently associated with a higher probability of death and had a similar impact on survival. A progressive association was observed between LVDD grades and mortality.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"66-73"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39309879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease.","authors":"Ruyi Cai,&nbsp;Lina Shao,&nbsp;Yifan Zhu,&nbsp;Yueming Liu,&nbsp;Jinshi Zhang,&nbsp;Qiang He","doi":"10.1111/nep.13967","DOIUrl":"https://doi.org/10.1111/nep.13967","url":null,"abstract":"<p><strong>Aims: </strong>In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy (LVH) than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>In this retrospective study, we reviewed the medical records of 289 adult patients with CKD from the Zhejiang Provincial People's Hospital in Zhejiang, China. Demographic, echocardiographic and brachial and central blood pressure parameters were retrieved from medical records. Central blood pressure was measured using the SphygmoCor® CvMS (AtCor, Australia) device and its corresponding software. Multivariate logistic regression analyses were performed to identify independent predictors of LVH. Receiver operating characteristic curves were used to determine the ability of central and brachial blood pressure to predict LVH.</p><p><strong>Results: </strong>The left ventricular mass index was positively associated with both central and brachial blood pressures. However, multiple logistic regression analysis demonstrated that a central pulse pressure (CPP) ≥ 58 mm Hg was an independent risk factor for LVH (OR = 5.597, 95%CI 2.363-13.259, p < .001). Brachial pulse pressure is not superior to CPP in predicting LVH (area under the curve [AUC] = 0.695, 95%CI 0.634-0.756, p < .001 vs. AUC = 0.687, 95%CI: 0.626-0.748, p < .001, respectively; p = .4824).</p><p><strong>Conclusion: </strong>Our results suggested that, similarly to the general population, CPP is a better parameter for predicting the occurrence of LVH in patients with CKD.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"57-65"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39342870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sofosbuvir plus velpatasvir combination for the treatment of chronic hepatitis C in patients with end stage renal disease on renal replacement therapy: A systematic review and meta-analysis.","authors":"Arka De,&nbsp;Akash Roy,&nbsp;Nipun Verma,&nbsp;Saurabh Mishra,&nbsp;Madhumita Premkumar,&nbsp;Sunil Taneja,&nbsp;Virendra Singh,&nbsp;Ajay Duseja","doi":"10.1111/nep.13968","DOIUrl":"https://doi.org/10.1111/nep.13968","url":null,"abstract":"<p><strong>Introduction: </strong>Sofosbuvir (SOF) and velpatasvir (VEL) is a pan-genotypic regimen for the treatment of Hepatitis C virus (HCV) infection. The data on the efficacy and safety of this regimen is end-stage renal disease (ESRD) is scanty. This systematic review and meta-analysis was done to ascertain the efficacy and safety of SOF and VEL in patients with chronic Hepatitis C (CHC) and ESRD on renal replacement therapy (RRT).</p><p><strong>Methods: </strong>Systematic search of Pubmed, Embase, Scopus, and Google Scholar was conducted using the search term (end-stage renal disease OR renal replacement therapy OR chronic kidney failure OR severe renal impairment OR chronic kidney disease OR haemodialysis OR dialysis OR peritoneal dialysis) AND (sofosbuvir OR velpatasvir OR NS5A inhibitors OR directly acting antivirals). Pooled sustained virologic response (SVR) and adverse event rates with 95% confidence intervals were estimated.</p><p><strong>Results: </strong>Seven studies (410 patients with CHC and ESRD on RRT) fulfilled our eligibility criteria. The overall pooled SVR rate of SOF and VEL in patients with HCV on RRT was 97.69% (95% CI: 95.71 to 98.92). There was no significant heterogeneity (I² : 39.3%, p-value of Cochran's Q = 0.13) among the studies. The pooled estimate of efficacy of SOF-VEL combination among patients with cirrhosis was 91.94% (95% CI 77.03-98.52). Pooled SVR rates in genotype 3 infection [94.6%, (95%: CI 81.3-99.4)] was comparable to that in those with documented non-genotype 3 infection [94.63%, (95% CI 87.12-98.44)]. No serious adverse event attributable to SOF and VEL was reported in the included studies.</p><p><strong>Conclusion: </strong>The fixed-dose combination of SOF and VEL is effective and safe in CHC patients with ESRD on RRT.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"82-89"},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/nep.13968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39361096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}