Hepatitis C in CKD

The Kidney Disease: Improving Global Outcomes (KDIGO) 2018 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease represents a complete update of the prior guideline published in 2008. Since the 2018 guideline publication, further evidence has accumulated in a number of areas, including the role of additional direct-acting antiviral regimens in the treatment of patients with HCV and CKD G1-G5 or CKD G5D, including kidney transplant recipients. Studies have also emerged attesting to the efficacy and safety of donor HCV+ to recipient HCV– kidney transplantation. This evidence will be addressed in a new KDIGO Hepatitis C Guideline Update, which will be published in 2022.

This guideline is intended to assist the practitioner caring for patients with hepatitis C virus (HCV) and chronic kidney disease (CKD), including those who are on chronic dialysis therapy and individuals with a kidney transplant. Specifically, the topic areas for which recommendations are issued include detection and evaluation of HCV in CKD; treatment of HCV infection in patients with CKD; management of HCV-infected patients before and after kidney transplantation; prevention of HCV transmission in hemodialysis units; and diagnosis and management of kidney diseases associated with HCV infection.

Additional Resources


Hepatitis C in Chronic Kidney Disease: An Overview of the KDIGO Guideline
Clinical Gastroenterology and Hepatology 2020


This Clinical Practice Guideline is based upon the best information available at the time of publication. The recommendations are designed to provide information and assist decision-making. They are not intended to define a standard of care, and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of this Guideline is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. The recommendations for research contained within this document are general and do not imply a specific protocol.