Association of reduced renal function with different phase of chronic hepatitis B virus infection

Background: The association between chronic hepatitis B virus (HBV) infection and the development of chronic kidney disease (CKD) remains controversial, and whether the cause is related to the different phases of chronic HBV infection remains unclear. Methods: A large cross-sectional study was performed to show the prevalence of reduced renal function during chronic HBV infection in adults from 7 multi-centers of Shenzhen City in China. Estimated glomerular filtration rate (eGFR) was used to evaluate the effect of HBV infection on the risk of renal impairment. Results: 33.04% HBsAg (+) patients had eGFR < 90, while patients without HBV exposure, 32.73% had eGFR < 90, showing no significant difference. There was no significant difference between those with elevated and normal alanine aminotransferase (ALT) in chronic hepatitis B (CHB) groups. Moreover, according to stratified statistics of different phases of the disease, liver cirrhosis, especially decompensated liver cirrhosis, hepatocellular carcinoma (HCC) showed a significant decrease in renal function compared with CBH (P = 0). Multivariate logistic regression analysis showed that liver disease different phases independently associated with reduced renal function. Conclusion: During the early CHB phase of chronic HBV infection (either elevated ALT or normal) did not increase the risk of renal dysfunction compares no exposure to HBV. However, when CHB progress to end-stage liver disease were associated with reduced kidney function. Additionally, Hoek formula should be recommended for patients with end-stage liver disease.