https://gastroenterology.acponline.org/archives/2023/12/22/6.htm

KDIGO updates guidelines on treating hepatitis C in chronic kidney disease

The latest recommendations from Kidney Disease: Improving Global Outcomes (KDIGO), which were recently summarized in Annals, address sofosbuvir treatment in patients with advanced chronic kidney disease, among other topics.


Guidelines on treating hepatitis C (HCV) in chronic kidney disease (CKD) were recently updated by Kidney Disease: Improving Global Outcomes (KDIGO).

The KDIGO 2022 clinical practice guideline, an update of the 2018 version, was summarized in Annals of Internal Medicine on Dec. 12.

The updated guideline includes 43 graded recommendations and 20 ungraded recommendations, seven of which are new or modified. New evidence motivated changes to recommendations regarding treatment of HCV infection in patients with CKD, management of HCV before and after kidney transplant, and diagnosis and management of kidney disease associated with HCV.

The updated guideline recommends expanding treatment of HCV with sofosbuvir-based regimens to patients with advanced CKD, including those on dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in patients with HCV.

The guideline will be assessed again to see if more updates are needed within the next three years, the KDIGO writing group said.