الفهرس 
Hepatitis C Virus Infection in chronic kidney DiseaseOnly 14 pages are availabe for public view
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Abstract
de novo and recurrent glomerulopathies are common in renal transplant patients with HCV infection and are associated with poorer allograft and patient survival. These patients should be closely monitored for the development of complications from HCV infection. A careful evaluation to identify the cause of renal dysfunction should be undertaken in these patients. Use of interferon therapy should be avoided. All patients should receive antiproteinuric therapy as tolerated and antiviral treatment may be considered. High-dose corticosteroids and plasma exchange may be used in acute and severe cases. Rituximab may be tried in refractory cases.
The prevalence of HCV infection varies by facility, but the average prevalence in hemodialysis patients is many times higher than in the general population. Identification of HCV seroconversions in hemodialysis patients frequently represents transmission that occurs within dialysis facilities and is preventable through adherence to recommended infection control practices.
Common lapses in infection control were responsible for recognized outbreaks of HCV infection in hemodialysis units during the past decade. Given the substantial number of facilities nationwide that conduct no screening of patients for HCV infection and barriers to public health reporting, these outbreaks likely represent only a fraction of all HCV transmissions in hemodialysis units.
It is unclear what impact the new CMS Conditions for Coverage will have on rates of HCV infection screening and detection. As public awareness of health care–associated HCV transmission and demand for transparency and accountability increase, infection caused by HCV or other blood-borne pathogens cannot be viewed as an acceptable or inevitable outcome of health care, including hemodialysis therapy.
An aggressive focus on staff education and infection prevention is needed in dialysis facilities, in conjunction with more widespread detection of infections to facilitate swift preventive action.