Guideline Updated for Managing Hepatitis C in Chronic Kidney Disease

TUESDAY, Dec. 12, 2023 (HealthDay News) -- The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease has been updated, according to a report published online Dec. 12 in the Annals of Internal Medicine.

Ahmed Arslan Yousuf Awan, M.D., from the Baylor College of Medicine in Houston, and colleagues reviewed and graded new evidence to update the 2018 guideline. The updated guideline includes 43 graded and 20 ungraded recommendations, of which seven are new or modified based on recent evidence. The guideline recommends expansion of hepatitis C treatment with sofosbuvir-based regimens to patients with chronic kidney disease glomerular filtration rate categories G4 and G5, which include those receiving dialysis. In addition, the guideline recommends expanding the donor pool for kidney transplant recipients by accepting hepatitis C-positive kidneys, irrespective of the hepatitis C virus (HCV) status of the recipient, and initiation of direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis, without the need for kidney biopsy. The guideline also addresses the use of immunosuppressive regimens in such patients.

"The 2022 update to the 2018 KDIGO guideline incorporates newer evidence confirming the safety and efficacy of sofosbuvir in patients with CKD G4 or G5 who are or are not receiving dialysis," the authors write.

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