Associations between hepatitis B infection and chronic kidney disease: 10-Year results from the U.S. National Inpatient Sample

Abstract

Introduction: Viral hepatitis infection is associated with negative impacts on renal function that may lead to nephropathy. We investigated associations between chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD) and/or end-stage renal disease (ESRD) in a large, representative sample from a nationwide U.S.

Methods: This population-based, retrospective observational study extracted data from the U.S. Nationwide Inpatient Sample (NIS) database, including adults ≥18 years old admitted to U.S. hospitals between 2005 and 2014 with records of chronic HBV infection in medical history. The final analytic sample included 70,674 HBV-infected patients and 282,696 matched non-HBV controls. Study endpoints were prevalent CKD and ESRD. Associations between CKD/ESRD and HBV and patients' clinical characteristics were determined by logistic regression analysis.

Results: HBV infection was associated with slightly increased risk of prevalent CKD (OR: 1.06, 95% CI: 1.004-1.119) and an approximate 2-times risk of prevalent ESRD (OR: 1.98, 95% CI: 1.880-2.086). HBV infection in both genders was associated with slightly increased risk of CKD (males, OR: 1.09, 95% CI: 1.02-1.16; females, OR: 1.07, 95% CI: 0.98,1.17), and significantly associated with increased risk for CKD among non-diabetic patients (OR: 1.23, 95% CI: 1.15-1.32), white patients (OR: 1.14, 95% CI: 1.06-1.23) and Asian/Pacific Islanders (OR: 1.13, 95% CI: 0.98-1.30).

Conclusions: Chronic HBV infection is associated with slightly increased risk for CKD and greater risk for ESRD in males and females, Whites and Asian/Pacific Islanders and non-diabetic patients.

Keywords: Chronic kidney disease (CKD); End-stage renal disease (ESRD); Enfermedad renal crónica (ERC); Enfermedad renal terminal (ERT); Hepatitis B; Muestra nacional de pacientes hospitalizados (NIS); U.S. Nationwide Inpatient Sample (NIS).