Original investigation: Pathogenesis and treatment of kidney disease and hypertensionHepatitis C virus-associated tubulointerstitial injury
Section snippets
Patients
We define a patient as a person who underwent percutaneous renal biopsy for the investigation and treatment of renal diseases at Kyoto University Hospital (Kyoto, Japan) between 1992 and 2000 and did not have diseases causative of TIN, such as infectious diseases other than HCV, congenital diseases, collagen diseases, cryoglobulinemia, diabetes mellitus, malignant diseases, and drug-induced TIN. A full history was obtained from each patient before the investigation. No patient had a history of
Case-control study
Of the 320 patients without extrarenal diseases causative of TIN, 13 patients had HCV infection and 307 patients did not. Case subjects with HCV infection included a significantly larger population with tubulointerstitial damage (10 of 13 patients) than HCV-negative controls (104 of 307 patients; Fisher's exact P = 0.0024; Table 4). These data suggest that HCV infection is associated with the prevalence of tubulointerstitial lesions.
Typical picture of TIN in HCV-infected patients
Frequent tubulointerstitial changes were observed in these
Discussion
Renal involvement of HCV infection has been documented as cryoglobulinemic nephropathy and various types of glomerulonephritis. We have identified an association between HCV infection and prevalence of tubulointerstitial injury in a case-control study. Compared with glomerular stage-matched controls with MN in another study, frequent tubulointerstitial inflammatory cell infiltration and fibrosis were observed in HCV-infected patients. In these patients, factors that affect tubulointerstitial
Acknowledgements
The authors thank Dr Kunitada Shimotohno (Institute for Viral Research, Kyoto University, Japan) for providing rabbit anti-HCV core antigen antisera; Yukiko Ano for technical assistance; Fumie Uemura for secretarial assistance; and Daniel Mrozek for help preparing the manuscript.
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