Clinicopathologic features and long-term prognosis of hepatitis B virus-associated glomerulonephritis: a retrospective cohort study

Background Hepatitis B virus-associated glomerulonephritis is a common form of secondary glomerulonephritis in China.

However, the clinicopathological features and long-term prognosis of Hepatitis B virus-associated Glomerulonephritis remain only partially known.

Methods Biopsy-proven Hepatitis B virus-associated Glomerulonephritis patients were enrolled between November 1994 and December 2013 at our center.

The composite endpoints were doubling serum creatinine, end-stage renal disease, or death from renal disease during follow-up.

The clinicopathological features and predictors of the long-term prognosis of Hepatitis B virus-associated Glomerulonephritis patients were explored.

Results The median age of the 259 Hepatitis B virus-associated Glomerulonephritis patients was 31.0 years (IQR 24.0–40.0), and 71.0% were males.

Among the patients, 45.2% presented with nephrotic syndrome, and 45.9% presented with proteinuria combined with hematuria.

The two most prevalent pathological patterns were IgA nephropathy (27.0%) and membranous nephropathy (27.0%).

The mean follow-up period was 68.8 ± 46.9 months.

The 3-, 5-, and 10-year clinical event-free survival rates were 93.4%, 85.2%, and 70.3%, respectively.

Multivariable Cox regression analysis showed that hypertension (HR 2.580, 95% CI 1.351–4.927, P  = 0.004), hyperuricemia (HR 2.101, 95% CI 1.116–3.954, P  = 0.021), glomerulosclerosis ( P  = 0.001), and intrarenal arterial lesions ( P  = 0.041) were independent predictors of composite clinical event endpoint.

Patients in the antiviral therapy group exhibited a significantly better prognosis compared to those who received no antiviral therapy (log-rank χ ^2 = 5.772, P  = 0.016).

Conclusion Hepatitis B virus-associated Glomerulonephritis has specific clinicopathologic features and should not be considered a benign disease in adults.

Hypertension, hyperuricemia, glomerulosclerosis, and intrarenal arterial lesions were independent predictors of the long-term prognosis in Hepatitis B virus-associated Glomerulonephritis patients.

Antiviral therapy could be effective in improving the long-term prognosis of Hepatitis B virus-associated Glomerulonephritis patients.

Graphic abstract