Hepatitis B and C and renal failure

Viral hepatitis has a special relationship to renal disease. Hepatitis B and C virus (HBV and HCV) infections are more prevalent in renal failure patients than in the general population. Viral hepatitis is an important cause of morbidity and mortality of renal failure patients on chronic dialysis and after renal transplantation. The association between viral hepatitis and renal failure is largely caused by the frequent use of blood products in patients with end-stage kidney disease and to the multiple invasive medical procedures to which these patients are exposed. The effects of renal failure on the general health and immune status of patients with renal disease also makes viral hepatitis more difficult to diagnose, as well as to manage. Finally, there have been few studies of the natural history and therapy of viral hepatitis in renal failure patients, making conclusions difficult. This article reviews the prevalence, incidence, the clinical features, and natural histories of HBV and HCV infection, and suggests recommendations for management and therapy in renal failure patients and patients undergoing renal transplantation.