Pretreatment Renal Biopsy Findings as a Predictor of Post Treatment Renal Function in Patients with Hepatitis C Virus Associated Nephropathy: A Prospective Study

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Background: Renal histopathological patterns are established predictors of outcomes in many disorders. However, its role in predicting outcomes in hepatitis C virus (HCV)-associated nephropathy has not been elucidated yet. The preset study aimed to assess utility of biopsy in predicting post treatment renal functions in HCV-associated nephropathy patients. Patients and Methods: Prospective study included HCV 30 nephropathy-established patients, recruited from Nephrology Unit of Internal Medicine Department from September 2016 to September 2017. Ultrasound-guided, percutaneous, needle biopsy was utilized to obtain the renal samples.
Results: Commonest form of HCV-associated glomerular disease was membranoproliferative (43.3%), followed by membranous glomerulonephritis (16.7%). Focal segmental glomerulosclerosis (FSGS), crescentic glomerulonephritis (CGN), and cryoglobulinemic were equally presented in 13.3% of the patients, each. Interstitial fibrosis was found in (73.3%), tubular atrophy in (70%), glomerular sclerosis in (46.7%), and arteriolosclerosis in (33.3%). Twelve weeks after new antiviral therapy, patients with moderate tubular atrophy exhibited statistically significant higher reductions in serum creatinine and urea levels than patients with severe form (-1.13 ±0.45 versus -0.71 ±0.56 mg/dL and -9.98 ± 1.67 versus -4.01±4.02 mg/dL, respectively; p =0.01). No significant difference between both groups was noted regarding 24-hours urinary protein and e-GFR. Patients with mild and moderate interstitial fibrosis and arteriolosclerosis exhibited statistically significant higher reductions in serum creatinine and urea levels. Tubular atrophy and Interstitial fibrosis significantly affect post treatment serum creatinine and urea (p <0.05).
Conclusion: Pretreatment renal histopathology significantly influence post treatment renal functions in HCV nephropathy patients.

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