Abstract
It has recently been shown that hepatitis C virus (HCV) infection is closely associated with mixed type cryoglobulinemia. It is also known that HCV infection is rampant among chronic hemodialysis patients. We studied 531 renal failure patients on chronic hemodialysis including 170 with positive HCV antibodies for cryoglobulinemia, and the frequency of cryoglobulinemia was compared with control groups consisting of 242 chronic hepatitis C patients without renal failure, and 183 healthy adults. Cryoglobulinemia was present in 30.6% of dialysis patients with HCV infection, 10.8% of dialysis patients without HCV infection, 29.8% of patients with chronic hepatitis C, and 0% of healthy adults. Among 30 new renal failure patients who had started on dialysis within the past 6 months, 4 were positive for HCV antibodies, and one (25%) had cryoglobulinemia; of the 26 HCV-negative patients, 4 (15%) were cryoglobulinemic. Cryocrit values among dialysis patients were much lower than those of the control and other reports. Patients with cryoglobulinemia were generally younger than negative patients. There was no correlation between cryoglobulinemia and past blood transfusion or length of dialysis. Thus, it seems that renal failure patients with HCV infection develop cryoglobulinemia less commonly compared with nondialysis patients, and that they develop cryoglobulinemia at relatively younger ages. There was no indication that the presence of cryoglobulin in serum adversely affects the liver nor increases the serum virus load in the HCV-infected dialysis patients. Patients with renal failure may be less capable of producing cryoglobulin than healthy individuals.
