The patients were excluded if they had: (1) concurrent hepatitis B or human immunodeficiency virus infections, autoimmune hepatitis, hemochromatosis, or Wilson��s disease; (2) systemic hypertension or if they reported current use of antihypertensive medication; (3) active alcohol consumption; former (4) antiviral or corticosteroid treatment; and (5) chronic renal disease or history of dialysis. The HCV patients who were candidates for treatment were given 180 ��g of peginterferon ��-2a (Pegasys?; Hoffmann-LaRoche, Basel, Switzerland) subcutaneously once weekly and ribavirin (Copegus?; Hoffmann-La Roche, Basel, Switzerland) at a daily oral dose of 1000 mg (body weight < 75 kg) or 1200 mg (body weight > 75 mg) for 48 wk. Laboratory measurement Testing for anti-HCV was carried out using a commercial ELISA kit (Axsym HCV version 3.
0; Abbott Laboratories, Chicago, IL, USA). All patients were HCV-G4 as detected by the Inno-LiPA HCV II assay (Innogenetics Inc., Alpharetta, GA, USA). Monitoring serum HCV RNA levels was by Amplicor (version 2.0, Hoffmann-La Roche) with a minimum detection limit of 50 IU/mL. Microalbuminuria was measured on a spot of second morning urine after an overnight fast, taking the mean of at least 2 samples collected for each subject. Urine albumin measurements were obtained by an automated immunoturbidometric assay (Roche Hitachi 902, Roche Diagnostics, Indianapolis, IN 46250 USA). For quantitative determination of creatinine in serum or urine, creatinine blanked kinetic Jaff�� (Roche Diagnostics, Hitachi 917, Modulator P analyzer Roche Diagnostics) was used.
We estimated GFR (eGFR) using the abbreviated modification of diet in renal disease equation. After an overnight fast, samples for cryoglobulin measurement were collected at a temperature of 37��C, centrifuged at 37��C for 10 min, and the serum separated; 5 mL of the serum was allowed to stand in a cryocrit tube at 4��C for 2-7 d, with formation of precipitate confirmed visually. If the test was positive we proceeded to electrophoresis and immunofixation for typing. All subjects were tested for cryoglobulin. Measures of renal insufficiency Three measures of renal insufficiency were examined, namely eGFR, microalbuminuria, and serum creatinine. Low eGFR was defined as eGFR < 60 mL/min every 1.73 m2.
The presence of microalbuminuria was tested using (1) albuminuria level; or categories of microalbuminuria, defined as individuals with an albuminuria level higher than the upper tertile of the albuminuria Carfilzomib level among controls (2) ACR: to adjust for the variation in urine concentration, microalbuminuria was assessed by ACR. Gender-specific values for the ACR were 2.2 mg/mmol for males and 2.8 mg/mmol for females. High levels of serum creatinine were defined as > 1.2 mg/dL for males and > 1.1 mg/dL for females. Outcomes and covariates definitions Subjects were considered diabetic if they had a fasting blood glucose level �� 5.