Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 22-14: Nephritic Spectrum Glomerular Diseases + Key Features Download Section PDF Listen +++ ++ Kidney disease can occur in the setting of HCV infection Three patterns of kidney injury associated with HCV Secondary MPGN (most common) Cryoglobulinemic glomerulonephritis Membranous nephropathy + Clinical Findings Download Section PDF Listen +++ ++ Depend on underlying pattern of injury + Diagnosis Download Section PDF Listen +++ ++ Elevated serum transaminases Elevated rheumatoid factor Hypocomplementemia is very common, with C4 typically more reduced than C3 Complement levels and rheumatoid factor tend to be normal if there is a membranous pattern of injury + Treatment Download Section PDF Listen +++ ++ Viral suppression or eradication is the cornerstone of treatment of HCV–associated kidney disease Use of most direct-acting antiviral agents appears to be safe in those with reduced GFR, with the exception of sofosbuvir Rituximab and possibly corticosteroids and plasmapheresis should be given to patients with severe vasculitis prior to the initiation of antiviral therapy