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Chronic viral hepatitis and chronic kidney disease
  1. Elias C Chacko1,
  2. Soondal Koomar Surrun1,
  3. T P Mubarack Sani2,
  4. Joseph M Pappachan3
  1. 1Department of Internal Medicine, Singapore General Hospital, Singapore
  2. 2Department of Community Medicine, Pariyaram Medical College, Kannur, South India
  3. 3Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
  1. Correspondence to Dr M J Pappachan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169608, Singapore; drpappachan{at}


Chronic kidney disease (CKD) has become a major public health problem worldwide over the past few decades because of the increasing prevalence of hypertension, diabetes mellitus, and elderly individuals in most countries. Chronic viral hepatitis (due to hepatitis B virus (HBV) and hepatitis C virus (HCV)) also poses significant morbidity and mortality globally. Both these viruses can cause CKD and these infections can occur as a consequence of CKD management. CKD patients acquiring HBV or HCV infection have higher morbidity and mortality rates, and the management of these infections among CKD patients with antiviral agents is associated with high rates of adverse effects. The optimal management of CKD associated with HBV and HCV is not well defined because of insufficient data from clinical trials. This review discusses the pathogenesis, clinical characteristics and management issues related to chronic viral hepatitis and CKD.

  • Chronic viral hepatitis, chronic kidney disease (CKD)
  • HBV associated CKD
  • HCV associated CKD and antiviral treatment
  • infectious diseases and infestations
  • hepatobiliary disease
  • nephrology
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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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