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- Title
Chronic hepatitis in end-stage renal disease: Comparison of HBsAg-negative and HBsAg-positive patients.
- Authors
Parfrey, Patrick S.; Farge, Dominque; Forbes, R. D. Clarke; Dandavino, Raymond; Kenick, Scott; Guttmann, Ronald D.
- Abstract
To determine the outcome of chronic hepatitis in ESRI) we studied all 358 renal transplant recipients and 295 hemodialysis patients treated for > 1 year since 1970. The incidence of chronic hepatitis (elevated SGOT for > 1 year) was 15% (N = 54) in transplanted and 3.4% (N = 10) in dialysis patients. Forty-eight percent (26) of transplanted and 50% (5) of dialysis patients were HBsAg positive. In the transplanted group. the clinical outcome of chronic hepatitis was significantly better in HBsAg-negative compared to HBsAg-positive patients; 11% died, none from liver disease, and 32% remitted after a mean follow-up from start of liver disease of 77.3 ± 8.2 months, whereas in the HBsAg-positive group 54% (14) died, nine from liver disease, and one remitted after a follow-up of 90.2 ± 8.9 months. Advent prognostic factors (age, duration of diabetes, and heart disease) present before ESRD treatment began were similar in both groups, as was duration of follow-up. Only14% (2⁄14) of HBsAg- negative patients progressed to chronic active hepatitis on liver biopsy compared to 11% (15⁄21) of HBsAg-positive patients. Histological stability in those with serial biopsies occurred in 66% (4⁄6) of HBsAg- negative patients, but in only 18% (13⁄16) of HBsAg-positive patients with a similar duration of follow-up. No dialysis patients died from liver disease. We conclude that chronic hepatitis occurs more frequently in transplanted than dialyzed patients. and that HBsAg-negative chronic hepatitis has a more benign. clinical, and histological outcome than chronic HBsAg-positive hepatitis in renal transplant recipients.
- Subjects
HEPATITIS; HEPATITIS B virus; KIDNEY diseases; HEMODIALYSIS; KIDNEY transplantation; NEPHROLOGY
- Publication
Kidney International, 1985, Vol 28, Issue 6, p959
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1985.224