New Global Guidelines for Kidney Disease and Hepatitis C

New York, NY
April 13, 2007

Experts have presented the first clinical practice guidelines for preventing, diagnosing and treating hepatitis C in patients with chronic kidney disease, who are at high risk of contracting the deadly virus. The guidelines will be discussed here today in detail at the National Kidney Foundation 2007 Spring Clinical Meetings in session #288, “New KDIGO Guidelines,” from 8:00-10:00 a.m.

“In the U.S., hemodialysis patients are several times more likely to be infected with hepatitis C, and in some countries, up to half of dialysis patients are infected,” says guideline co-author Dr. Michel Jadoul. “All of our patients, especially those who might experience nosocomial transmission in dialysis units, and those who received an unscreened blood transfusion or graft, are at risk. Here’s how you can keep them safe.”

The guidelines recommend that patients infected with the hepatitis C virus (HCV) should all be tested for CKD, and treatment of hepatitis C should be considered in patients with CKD before undergoing transplantation, due to the risk of allograft glomerulonephritis in untreated patients, and the risk of graft rejection if treatment is initiated after transplantation.

“Often, clinicians choose not to treat HCV-infected non-CKD patients if their lesions are mild,” says Dr. Jadoul, based at the Cliniques Universitaires St Luc,Univ.Cath. de Louvain in Brussels . “But for CKD patients, waiting until after transplantation to treat HCV is too risky, so we are suggesting that clinicians consider treating all patients with HCV infection before they undergo transplantation, regardless of the results of their liver biopsies.”


Other recommendations include:

  • Test all dialysis patients, transplant candidates, and kidney donors for HCV.
  • All patients with HCV infection, regardless of treatment or treatment response, should be followed for HCV-associated comorbidities. Patients with clinical or histologic cirrhosis should undergo follow-ups every six months.
  • Infection control procedures in hemodialysis units should include hygienic precautions that prevent the transfer of blood or fluids contaminated with blood between patients, either directly or via contaminated equipment or surfaces.

“The statements emphasize that careful application of basic hygienic precautions is the cornerstone of the prevention of HCV transmission. This is in contrast to what happens in many countries outside the U.S., where isolation is performed,” says Dr. Jadoul. “The guidelines also recommend implementing regular observational audits of hygienic precautions, which is a new precaution.”

Dr. Jadoul will present the new guidelines in more detail, and discuss the strength of the scientific evidence to support each guideline statement.

Kidney Disease: Improving Global Outcomes (KDIGO) is a not-for-profit Belgian foundation with an international Board that is managed by the National Kidney Foundation. Its mission is to improve outcomes for kidney patients worldwide through coordination, development and implementation of practice guidelines.

To learn more about KDIGO visit www.kdigo.org. For more information on the National Kidney Foundation or the Spring Clinical Meetings visit www.kidney.org.