Hepatitis B virus infection and development of chronic kidney disease: A cohort study

Yun Soo Hong, Seungho Ryu, Yoosoo Chang, Miguel Caínzos-Achirica, Min Jung Kwon, Di Zhao, Tariq Shafi, Mariana Lazo, Roberto Pastor-Barriuso, Hocheol Shin, Juhee Cho, Eliseo Guallar

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: The effect of chronic hepatitis B virus (HBV) infection on the risk of chronic kidney disease (CKD) is controversial. We examined the prospective association between hepatitis B surface antigen (HBsAg) serology status and incident CKD in a large cohort of men and women. Methods: Cohort study of 299,913 adults free of CKD at baseline who underwent health screening exams between January 2002 and December 2016 in South Korea. Incident CKD was defined as the development of an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 and/or proteinuria. Results: Over 1,673,701 person-years of follow-up, we observed 13,924 incident cases of CKD (3225 cases of eGFR < 60 ml/min/1.73m2 and 11,072 cases of proteinuria). In fully adjusted models comparing positive to negative HBsAg participants, the hazard ratio (HR, 95% confidence interval) for incident CKD was 1.11 (1.03-1.21; P = 0.01). The corresponding HR for incident proteinuria and for eGFR < 60 ml/min/1.73m2 were 1.23 (1.12-1.35; P < 0.001) and 0.89 (0.73-1.07; P = 0.21), respectively. The associations were similar across categories of liver enzyme levels at baseline. Conclusion: In this large cohort, HBsAg positive serology was associated with higher risk of incident CKD, and we provide novel evidence that this association was due to a higher incidence of proteinuria in HBsAg positive participants. Our study adds to the growing body of evidence suggesting that chronic HBV infection may be a contributor to the increasing incidence of CKD.

Original languageEnglish (US)
Article number353
JournalBMC Nephrology
Issue number1
StatePublished - Dec 11 2018


  • Chronic kidney disease
  • Cohort study
  • Hepatitis B surface antigen
  • Hepatitis B virus infection
  • Proteinuria
  • Risk factors

ASJC Scopus subject areas

  • Nephrology


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