Hepatitis C in CKD

The 2022 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease (CKD) and Executive Summary are now published online in Supplement to Kidney International and Kidney International, respectively. The Guideline was co-chaired by Michel Jadoul, MD (Belgium), and Paul Martin, MD (United States).

The KDIGO 2022 Hepatitis C in CKD Guideline follows four years after the last clinical practice guideline on this topic in 2018. The 2022 Hepatitis C in CKD Guideline addresses new evidence that has accumulated in several areas, including the role of additional direct-acting antiviral regimens in treating patients with hepatitis C virus (HCV) and CKD G1-G5 or CKD G5D, including kidney transplant recipients. The guideline also addresses studies attesting to the efficacy and safety of kidney transplantation from donors with HCV to recipients who are HCV negative, and the role of kidney biopsy in managing HCV-associated glomerulonephritis.

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

Development of the Hepatitis C in CKD Guideline followed KDIGO’s explicit process of systematic evidence review. Appraisal of the quality of the evidence and the strength of recommendations followed the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach. Limitations of the evidence were discussed, with areas of future research also presented.

Read the full News Release.


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.