Prevalence of subclinical cryoglobulinemia in maintenance hemodialysis patients and kidney transplant recipients

We studied the prevalence and the clinical spectrum of cryoglobulinemia (Cryo) among 101 maintenance hemodialysis (HD) patients and 148 kidney transplant (KT) recipients, with or without chronic hepatitis C virus (HCV) infection. Cryo was present in 32% (16 of 50) of the HCV-positive HD patients, 5.9% (3 of 51) of the HCV-negative HD patients, 37.8% (28 of 74) of the NOV-positive KT recipients, and 27% (20 of 74) of the NOV-negative KT recipients. Cryoprecipitate in 56.3% (9 of 16) of the NOV-positive Cryo HD patients and 53.8% (14 of 26) of the NOV-positive Cryo KT recipients contained NOV-RNA. Interestingly, the cryocrit values among HD and KT patients were much lower than these in other reports on nonrenal failure cases. Also, the cryoglobulinemic syndrome (with purpura, arthralgia, etc.) in HD and KT patients with Cryo were not common (Tables 1 and 2), There was no correlation between Cryo and age, sex, and liver function. Only longer duration of end-stage renal disease was noted in these patients with Cryo, Nevertheless, there was no indication that the presence of cryoglobulin in serum adversely affected the renal function in KT recipients. This study confirms the association of Cryo and HCV in HD and KT patients. In addition, we suggested that KT patients are more susceptible to having Cryo, Further studies are necessary to better define whether any other subclinical viral or nonviral chronic infection may induce Cryo in NOV-negative KT recipients. (C) 2000 by the National Kidney Foundation, Inc.