The National Kidney Foundation Releases Commentary on Hepatitis C Guidelines for Clinicians
April 9, 2020, New York, NY— HepatitisC virus (HCV) infection is of particular concern in patients with chronic kidney disease (CKD). There is a much higher prevalence of HCV infection in the CKD/end-stage kidney disease (ESKD) population than is found in the general population. HCV can also cause kidney disease.
Global evidence-based clinical practice guidelines for the diagnosis and management of HCV in kidney patients were published by Kidney Disease Improving Global Outcomes (KDIGO) in 2018. To provide guidance to nephrologists on how these recommendations should be applied and implemented in the US, the National Kidney Foundation (NKF) has provided commentary in the“National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) Commentary on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation and Treatment of Hepatitis C.”
The guidelines cover five key aspects of care of HCV-infected CKD patients: diagnosis, treatment, prevention of transmission in dialysis units, management of kidney transplant patients, and management of HCV-associated kidney diseases.
NKF’s KDOQI commentary, which will be published online in the American Journal of Kidney Disease (AJKD) April 9, is generally supportive of applying the guideline in U.S. practice. However, NKF’s team challenged important components of that guideline in the context of additional research and experience. They questioned the directive about allocation of HCV-infected organs only to recipients who are also infected with HCV.
NKF’s team of investigators believe that “in an era where highly effective direct acting antiviral agents are available that eradicate the virus in virtually all patients, one must consider why these kidneys should not be offered to HCV negative patients on the waitlist as well,” said lead investigator David Roth, MD, of the Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine.
“This commentary is a great example of how KDOQI can assist practitioners in deciding how best to implement a global guideline in the US clinical practice environment,” said Kerry Willis, PhD, NKF Chief Scientific Officer.
“The authors wrote this commentary to be of value to practicing nephrologists who want to distill the KDIGO guideline into those important aspects that would be relevant to their practice,” Dr. Roth said. “One could choose to read the entire manuscript or just focus on those areas that are relevant to a particular patient or their practice as a whole.”
NKF gathered a team of experts in nephrology, transplantation, hepatology, and infectious diseases to analyze the KDIGO guidelines and provided the most up-to-date perspectives on the evolving field.
The guidelines will appear in AJKD April 9. AJKD is the leading kidney disease journal. It reaches thousands of healthcare professionals each month. To read more about the authors and to read the commentary, please visit, please visit https://www.ajkd.org/article/S0272-6386(20)30527-8/fulltext
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Kidney Disease Facts
In the United States, 37 million adults are estimated to have chronic kidney disease—and more than 90 percent are not aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.