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.
“KDIGO completed a full update of the Hepatitis C in CKD Guideline in 2018, but the new evidence that has emerged over the last four years made clear to us that an update was warranted,” said Dr. Martin. “We hope these new recommendations will help clinicians around the world improve outcomes for patients with HCV and CKD.”
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.
“We are delighted to present this guideline to the global kidney community,” said Dr. Jadoul. “We thank the Guideline Work Group and evidence review team for their time, expertise, and contributions in this important endeavor.”