A follow-up study involving more than 460,000 people found that patients with hepatitis B are more susceptible to kidney damage
Author: Hu Min Qi Release Date: 2018-07-16 Ageing, smoking, obesity, diabetes, hypertension, and cardiovascular and cerebrovascular diseases are all known risk factors for chronic kidney disease. A recent study by the Peking University School of Public Health suggests that patients with chronic hepatitis B virus (HBV) infection have a significantly increased risk of developing chronic kidney disease, and HBV infection is also a definite risk factor for kidney damage. Recently, the conclusion of this study was published in BMC Medicine. Increased risk of disease by 37% China is a moderately high endemic area of ​​hepatitis B virus (HBV) infection. In 2014, the World Health Organization estimated that the positive rate of hepatitis B surface antigen (HBsAg) in the general population in China was 5.49%. At the same time, chronic kidney disease is also one of the important public health problems in China. According to the results of the 2012 epidemiological survey in China, the prevalence of chronic kidney disease in Chinese adults is 10.8%, and the total number is as high as 120 million. Both clinical and laboratory studies suggest a link between these two chronic diseases, and HBV infection may impair kidney function. It is only this association that has long lacked evidence of large-scale population studies. This research by the team of Professor Li Liming of Peking University School of Public Health gives a positive answer. One of the authors of the paper, Lu Wei, a professor at Peking University School of Public Health, said that the team officially launched the China Chronic Disease Prospective Research Project (CKB) on January 1, 2004. The project was carried out in 10 provinces (regions) in China. It involves more than 510,000 people and lasts for 15 to 20 years. It is a multi-factor, multi-disease, multi-disciplinary collaboration on the epidemiology of large-scale chronic diseases and is currently the world's largest prospective study of long-term preservation of biological samples. One of the crowd cohort studies. This latest achievement is based on the 469,459 Chinese adults aged 30-79 who were recruited by the CKB program, with an average follow-up of 9.1 years of data analysis. This study showed that HBsAg positive was significantly associated with the risk of developing chronic kidney disease. Compared with HBsAg-negative patients, HBsAg-positive people have a 37% increased risk of developing chronic kidney disease, with a greater threat to men and a 77% increase in risk. It is worth noting that as the disease progresses, if the infected person develops into chronic hepatitis or cirrhosis and receives baseline treatment, the risk of chronic kidney disease in these patients will increase nearly fourfold. Lv Wei said that before this, the study on the relationship between HBV infection and chronic kidney disease was carried out in Taiwan and mainland China, but the sample size was less than 100,000 and limited to a certain area. This study is by far the largest population cohort study, including urban and rural populations. “To conduct a similar large-scale cohort study, it is necessary to conduct long-term follow-up monitoring of the cohort on the basis of on-site investigation to determine the HBV infection status of hundreds of thousands of people, and to collect the incidence of chronic kidney disease. This process itself is very difficult. It is not difficult to understand that this is also an important reason for the lack of relevant research data. The correlation mechanism is not clear The risk of chronic kidney disease in HBV-infected patients increases, so how does this association occur? According to Wang Guiqiang, director of the Department of Infectious Diseases at Peking University Hospital, first of all, for patients with severe liver disease, such as liver failure and advanced cirrhosis, renal complications are clinically very common. In ordinary hepatitis B patients, the virus-related renal function damage, that is, the detection of hepatitis B virus markers in kidney tissue, is called HBV-associated nephritis. In 1971, HBV antigen was first discovered in the glomerular basement membrane immune complex of a 53-year-old male membranous nephropathy. Since then, studies have reported that HBV infection is associated with various pathological types of glomerulonephritis. . However, Wang Guiqiang also said that so far, the research data of domestic HBV-associated nephritis is rare, and the treatment mechanism is not completely clear objectively. Among them, one of the most widely accepted classical interpretations is the deposition of viral antigens and host antibody immune complexes. He said that after the hepatitis B virus invasion, the body's immunity will be activated, resulting in antibodies. The combination of antigen and antibody forms an immune complex, which is deposited in the kidney, causing local lesions, inflammation, etc. to the glomerular basement membrane. This type of renal damage is called membranous glomerulonephritis. Other studies have shown that the HBV virus is not a strict hepadnavirus, it can directly cause renal damage. Because of the pathological examination, there are viral replication, viral particles or viral antigens in the kidneys. In response to this explanation, there is no final conclusion. In addition, the Peking University research team that published the above paper said in an interview with the Journal of Chinese Academy of Sciences that it is impossible to rule out the possibility of certain drugs for treating chronic liver disease having nephrotoxicity. "In the future, it is necessary to further collect specific medication information for HBV-infected patients, and it is expected to clarify this issue." "Drug-induced kidney damage" is itself a common toxic reaction. Wang Guiqiang pointed out that some anti-hepatitis B virus drugs on the market may have potential renal damage, while some drug side effects are not obvious. Taking lamivudine, adefovir, entecavir and telbivudine as an example, the current study shows that lamivudine and entecavir have little effect on the kidneys. Adefovir dipivoxil does have some side effects, but the dose used clinically is relatively small. The latest research shows that telbivudine can also play a role in improving kidney function. Protection needs good habits If HBV infection increases the risk of chronic kidney disease, then with the aging of the population, chronic kidney disease will become one of the important diseases that threaten the health of our population. To effectively reduce this risk, patients with chronic HBV infection must pay attention to the protection of the kidneys. In this regard, Wang Guiqiang stressed that the most important method is to standardize the diagnosis and treatment, especially those with HBsAg positive infection, should receive anti-viral treatment in time. "Antiviral therapy can not only effectively control the progression of HBV-infected diseases, but also solve the problem of HBV-associated nephritis in most cases." He also pointed out that the hepatitis B population must regularly monitor follow-up in order to adjust the treatment at any time. "Many patients are due to poor treatment compliance, do not listen to doctors or interrupt treatment, can not find the development of the disease in time, thus affecting the efficacy." As for the kidney damage that may be caused by drugs that treat HBV infection, Wang Guiqiang's view is that it is not a high probability event and is clinically controllable. "Anti-virus is still the first. If you refuse to take the drug because you are afraid of the side effects of the drug, this is completely wrong." In addition, there is a new discovery in this study. According to the researchers, chronic HBV infection can synergize with smoking, less physical activity, and diabetes. HBsAg-positive people who smoke or have less physical activity are twice as likely to develop chronic kidney disease as adults, and those with diabetes are six times more likely to develop chronic kidney disease than the average person. Lv Wei said that this also gives an important reminder. "For people with chronic HBV infection, they should develop a healthy lifestyle, do not smoke or quit early, increase physical activity, prevent diabetes or actively manage and control blood sugar, and pay attention to kidney function in regular physical examinations." Chinese Journal of Science (2018-07-13 8th Edition) Source: Chinese Journal of Science Night Vision Baby Monitor(hot) Night Vision Baby Monitor,Wireless 1080P Cameras,Wireless Camera Doorbell,Ring Doorbell Shenzhen Zuomi Technology Co., Ltd. , https://www.zuomicamera.com