Pathology of Hepatitis c Nephropathy

Study Overview
=================
Brief Summary
-----------------
Hepatitis c associated glomerulonephritis is an immune complex disease that occurs in 21% of patients who have HCV infection.

Detailed Description
-----------------
Hepatitis C virus infection is a major public health problem with an estimated global prevalence of 3% and an estimated 5-20% of infected patients will develop liver cirrhosis .The Prevalence of Hepatitis C infection in end stage renal disease is greater than in the general population especially in those on hemodialysis which reflects nosocomial transmission of the disease in the hemodialysis environment. Hepatitis C associated glomerulonephritis is an immune complex disease that occurs in 21% of patients who have HCV infection. It most commonly presents as membranoproliferative and mixed cryoglobulinemia It characterized by an indolent course in one third of patients , remission in another third and relapsing course in the remaining patients with potential progression to advanced chronic kidney disease. mechanism of injury : Chronic Hepatitis C is primarily associated with type II cryoglobulinemia , in which the primary mechanism of injury is vasculitis that occurs via immune complex deposition. hepatitis C virus related glomerular disease : Type I membranoproliferative was the most common finding associated with mixed cryoglobulinemia but other forms of glomerulonephritis were associated with Hepatitis c like mesangial glomerulonephritis,focal and segmental glomerulonephritis,minimal change nephropathy,membranous nephropathy , Fibrillary glomerulonephritis,immunotactoid glomerulopathy,IgA nephropathy, vasculitic renal involvement ,poly arteritis nodosa and interstitial nephritis .

Official Title
-----------------
Different Histopathological Patterns in Patients With HCV Nephropathy

Conditions
-----------------
Cryoglobulinaemia Due to Chronic Hepatitis C

Intervention / Treatment
-----------------
* Diagnostic Test: renal biopsy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: it will be conducted on chronic hepatitis C patients with chronic kidney disease . The participants will be classified according to their estimated GFR by modified MDRD equation and they will be recruited from the renal unit of internal medicine, Assiut University Hospitals and assiut hepatitis viruses unit-ministry of health, Egypt. Exclusion Criteria: Patients will be excluded if the underlying causes of CRF are as follows: chronic pyelonephritis,obstructive uropathy,Polycystic kidney disease,Patients with ESRD on regular hemodialysis,patients with advanced liver cirrhosis,hepatocellular carcinoma,Patients on steroids or immunosuppressive drugs and Solitary kidney.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| study group<br>patients with hepatitis c nephropathy detected by lab and renal biopsy | Diagnostic Test: renal biopsy<br>* needle biopsy will be taken from the kidney tissue then, diagnosed<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| prevalence of histopathological pattern in patients with hepatitis C virus | prevalence of histopathological pattern in patients with hepatitis C virus | one year |