中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 10
Oct.  2022
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(10): 2236-2241

Correlation analysis of hepatic fibrosis and renal injury in patients with chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2022.10.008
  • 1.

    Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221000, China

  • 2.

    The 71st Group Army Hospital of CPLA Army, Infectious Department, Xuzhou, Jiangsu 221000, China

  • 3.

    The Affiliated Hospital of Xuzhou Medical University, Infectious Department, Xuzhou, Jiangsu 221000, China

  • 4.

    The Affiliated Suqian First People's Hospital of Nanjing Medical University, Infectious Department, Suqian, Jiangsu 223800, China

More Information
  • Corresponding author: YAN Xuebing, yxbxuzhou@126.com(ORCID: 0000-0003-4689-7389)
  • Received Date: 2022-03-09
  • Accepted Date: 2022-04-17
  • Published Date: 2022-10-20
    Abstract
  •   Objective  To analyze the relationship between liver fibrosis and renal injury in patients with chronic hepatitis B (CHB).  Methods  We retrospectively analyzed the renal function of 798 CHB patients who were enrolled from May 2010 to October 2019. According to the quartile of fibrosis-4 (FIB-4) index, the population was divided into four groups: group Q1 (FIB-4≤0.74), group Q2 (0.74 < FIB-4 < 1.13), Q3 group (1.13≤FIB-4 < 2.0), and Q4 group (FIB-4≥2.0). The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between multiple groups. The chi-square test was used for comparison of categorical data between groups. Spearman partial correlation analysis was used to determine the relationship between FIB-4 and estimated glomerular filtration rate (eGFR). Multivariate Logistic regression model was used to assess the risk factors of renal injury using odds ratio (OR) and 95% confidence intervals (CI). Multiple Logistic regression was used to analyze the relationship between FIB-4 and renal injury in different groups.  Results  Because FIB-4 was correlated with age (r=0.650, P < 0.001), Spearman partial correlation analysis was used to adjust for age and gender. We found FIB-4 index was significantly associated with ALT, AST, ALP, GGT, LDH, TBil, DBil, TP, Alb, Glo, TBA, LAP, PLT, HBV DNA, AFP and eGFR (r values were 0.202, 0.354, 0.292, 0.287, 0.222, 0.377, 0.361, -0.085, -0.412, 0.168, 0.422, 0.427, 0.247, -0.421, 0.172, 0.318, -0.359, respectively, all P < 0.001). eGFR was negatively correlated with FIB-4 (R2=0.192 9). Multivariate logistic regression analysis found that HBV DNA(OR=1.227, 95%CI: 1.038-1.452, P=0.017), FIB-4(OR=1.581, 95%CI: 1.359-1.839, P < 0.001) were independent risk factors for renal injury. The AUC value of FIB-4 in predicting renal injury was 0.74 (95%CI: 0.67-0.82, P < 0.001), with a sensitivity of 0.47, a specificity of 0.93, and an optimal cutoff value of 3.48.  Conclusions  The degree of liver fibrosis in CHB patients is associated with the risk of renal injury.

     

    • FullText(HTML)
  • loading
    • References(22)
  • [1]
    HE P, FENG GH. Current research on the mechanism of direct damage of kidney tissue by virus in hepatitis B virus-associatednephritis[J]. Chin J Infect Dis, 2012, 30(2): 123-125. DOI: 10.3760/cma.j.issn.1000-6680.2012.02.016.

    何平, 冯国和. 乙型肝炎病毒相关性肾炎中病毒直接损伤肾组织作用机制研究现状[J]. 中华传染病杂志, 2012, 30(2): 123-125. DOI: 10.3760/cma.j.issn.1000-6680.2012.02.016.
    [2]
    ZHOU Y, YUAN WJ. Status of virus directdamage in the pathogenesis of hepatitis B virus-associated nephritis[J]. Chin J Neahrol, 2010, 26(8): 646-648. DOI: 10.3760/cma.j.issn.1001-7097.2010.08.021.

    周益, 袁伟杰. 病毒直接损伤作用在乙肝相关性肾炎发病机制中的地位[J]. 中华肾脏病杂志, 2010, 26(8): 646-648. DOI: 10.3760/cma.j.issn.1001-7097.2010.08.021.
    [3]
    TAKEKOSHI Y, TANAKA M, MIYAKAWA Y, et al. Free "small" and IgG-associated "large" hepatitis B e antigen in the serum and glomerular capillary walls of two patients with membranous glomerulonephritis[J]. N Engl J Med, 1979, 300(15): 814-819. DOI: 10.1056/NEJM197904123001502.
    [4]
    ADLER S, SALANT DJ, DITTMER JE, et al. Mediation of proteinuria in membranous nephropathy due to a planted glomerular antigen[J]. Kidney Int, 1983, 23(6): 807-815. DOI: 10.1038/ki.1983.99.
    [5]
    CHENG WR, SUN LJ, DONG HR, et al. Clinical and pathological characteristics of hepatitis B virus-associated glomerulonephritis in adults[J]. Int J Virol, 2021, 28(3): 231-235. DOI: 10.3760/cma.j.issn.1673-4092.2021.03.013.

    程文荣, 孙丽君, 董鸿瑞, 等. 成人乙型肝炎病毒相关性肾小球肾炎的临床及病理特点分析[J]. 国际病毒学杂志, 2021, 28(3): 231-235. DOI: 10.3760/cma.j.issn.1673-4092.2021.03.013.
    [6]
    GUPTA A, QUIGG RJ. Glomerular diseases associated with hepatitis B and C[J]. Adv Chronic Kidney Dis, 2015, 22(5): 343-351. DOI: 10.1053/j.ackd.2015.06.003.
    [7]
    AN ML, HE P. Research progress on mechanism of podocyte injury and its relationship with glomerular diseases[J]. Chin J Clin Res, 2018, 31(10): 1427-1431. DOI: 10.13429/j.cnki.cjcr.2018.10.033.

    安梦丽, 何平. 足细胞损伤的机制及与肾小球疾病的关系研究进展[J]. 中国临床研究, 2018, 31(10): 1427-1431. DOI: 10.13429/j.cnki.cjcr.2018.10.033.
    [8]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [9]
    REVILL PA, CHISARI FV, BLOCK JM, et al. A global scientific strategy to cure hepatitis B[J]. Lancet Gastroenterol Hepatol, 2019, 4(7): 545-558. DOI: 10.1016/S2468-1253(19)30119-0.
    [10]
    HONG YS, RYU S, CHANG Y, et al. Hepatitis B virus infection and development of chronic kidney disease: a cohort study[J]. BMC Nephrol, 2018, 19(1): 353. DOI: 10.1186/s12882-018-1154-4.
    [11]
    FABRIZI F, CERUTTI R, RIDRUEJO E. Hepatitis B virus infection as a risk factor for chronic kidney disease[J]. Expert Rev Clin Pharmacol, 2019, 12(9): 867-874. DOI: 10.1080/17512433.2019.1657828.
    [12]
    LIU Y, FAN R, CHEN J, et al. Assessment of renal function and risk factors for renal impairment in patients with hepatitis B virus-related liver cirrhosis[J]. J South Med Univ, 2014, 34(4): 472-476. DOI: 10.3969/j.issn.1673-4254.2014.04.07.

    刘颖, 樊蓉, 陈简, 等. 慢性乙型肝炎病毒感染相关肝硬化患者的肾功能及危险因素分析[J]. 南方医科大学学报, 2014, 34(4): 472-476. DOI: 10.3969/j.issn.1673-4254.2014.04.07.
    [13]
    DUAN Y, WANG XM, ZHAO YY, et al. Prevalence and influencing factors of chronic hepatitis B virus infection complicated with chronic kidney disease[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition), 2018, 12(5): 422-426. DOI: 10.3877/cma.j.issn.1674-1358.2018.05.002.

    段英, 王笑梅, 赵莹莹, 等. 慢性乙型肝炎病毒感染者合并慢性肾脏病患病率及影响因素[J/CD]. 中华实验和临床感染病杂志(电子版), 2018, 12(5): 422-426. DOI: 10.3877/cma.j.issn.1674-1358.2018.05.002.
    [14]
    ZHOU JT, LI JB. Evaluation of renal function and risk factors in patients with chronic hepatitis B[J]. Anhui Med J, 2017, 38(6): 681-684. DOI: 10.3969/j.issn.1000-0399.2017.06.002.

    周静婷, 李家斌. 不同程度慢性乙型肝炎患者肾功能评估及危险因素分析[J]. 安徽医学, 2017, 38(6): 681-684. DOI: 10.3969/j.issn.1000-0399.2017.06.002.
    [15]
    TARGHER G, BERTOLINI L, RODELLA S, et al. Relationship between kidney function and liver histology in subjects with nonalcoholic steatohepatitis[J]. Clin J Am Soc Nephrol, 2010, 5(12): 2166-2171. DOI: 10.2215/CJN.05050610.
    [16]
    XU HW, HSU YC, CHANG CH, et al. High FIB-4 index as an independent risk factor of prevalent chronic kidney disease in patients with nonalcoholic fatty liver disease[J]. Hepatol Int, 2016, 10(2): 340-346. DOI: 10.1007/s12072-015-9690-5.
    [17]
    SONNEVELD MJ, BROUWER WP, CHAN HL, et al. Optimisation of the use of APRI and FIB-4 to rule out cirrhosis in patients with chronic hepatitis B: results from the SONIC-B study[J]. Lancet Gastroenterol Hepatol, 2019, 4(7): 538-544. DOI: 10.1016/S2468-1253(19)30087-1.
    [18]
    LI X, ZHANG ZH, CAI Q, et al. Judgement of liver fibrosis by gama-glutamyltransferase to qHBsAg ratio in patients with chronic hepatitis B[J]. J Pract Hepatol, 2015, 18(2): 141-144. DOI: 10.3969/j.issn.1672-5069.2015.02.009.

    李旭, 张振华, 蔡群, 等. 谷氨酰转肽酶/HBsAg比值评估慢性乙型肝炎患者肝纤维化的价值探讨[J]. 实用肝脏病杂志, 2015, 18(2): 141-144. DOI: 10.3969/j.issn.1672-5069.2015.02.009.
    [19]
    LI Q, HUANG YX, CHEN L. The diagnostic value of γ-GT/plateletmodel for liver fibrosis and cirrhosis in patients with chronic hepatitis B[J]. Chin J Infect Dis, 2016, 34(6): 360-361. DOI: 10.3760/cma.j.issn.1000-66802016.06.009.

    李强, 黄玉仙, 陈良. γ-谷氨酰转肽酶/血小板计数模型对慢性乙型肝炎患者明显肝纤维化和肝硬化的诊断价值[J]. 中华传染病杂志, 2016, 34(6): 360-361. DOI: 10.3760/cma.j.issn.1000-66802016.06.009.
    [20]
    KIM WR, BERG T, ASSELAH T, et al. Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients[J]. J Hepatol, 2016, 64(4): 773-780. DOI: 10.1016/j.jhep.2015.11.012.
    [21]
    SU XN, CAO JY, JIN Z, et al. Study on semi-quantitative analysis of liver cirrhosis by ultrasound elastography Q analysis technique[J]. Chin J Med Offic, 2021, 49(12): 1319-1322. DOI: 10.16680/j.1671-3826.2021.12.09.

    苏晓妮, 曹军英, 金壮, 等. 超声弹性成像Q分析技术对肝硬化半定量分析研究[J]. 临床军医杂志, 2021, 49(12): 1319-1322. DOI: 10.16680/j.1671-3826.2021.12.09.
    [22]
    FU F, WANG MY, SHI DP, et al. Evaluation of hepatic fibrosis in chronic hepatitis B with parameters obtained from multi-models of diffusion-weighted MRI[J]. Chin J Radiol, 2018, 52(2): 113-118. DOI: 10.3760/cma.j.issn.1005-1201.2018.02.007.

    付芳芳, 王梅云, 史大鹏, 等. 多种模型MRI扩散加权成像评估慢性乙型病毒性肝炎肝纤维化程度的价值[J]. 中华放射学杂志, 2018, 52(2): 113-118. DOI: 10.3760/cma.j.issn.1005-1201.2018.02.007.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (404) PDF downloads(77) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return