Kidney biopsies were performed on patients who developed abnormal renal function or reduction of GFR, either before or during therapy according to the normal unit indications. HCV treatment protocol used This was based on the standard international guidelines for therapy of hepatitis C. However because these are a special group of patients sellekchem and since there is no agreed-on defined protocol to treat such patients and as our study is a retrospective, the individual treatment protocol was left to the discretion of the treating hepatologist. Pegylated interferon ��-2a (Pegasys, F. Hoffmann-la Roche Ltd., Basel, Switzerland) at a dosage of 135-180 ��g (135 ��g for 2 patients and 180 ��g for 13 patients) every week in combination with ribavirin 400 mg (2 patients), 800 mg (11 patients), 1000 mg (1 patient), 1200 mg (1 patient) daily in two divided doses were given to 15 patients.

Pegylated interferon ��-2b (Peg-intron, Schering-Plough Corporation, Kenilworth, NJ, United States) at a dosage of 80-100 ��g every week, in combination with ribavirin 400 mg (1 patients), 800 mg (3 patients) daily in divided doses were given to the remaining 4 patients. All patients were treated for 48 wk. Patients whose hemoglobin dropped to below 100 mg/dL were given erythropoietin subcutaneously, and those whose absolute neutrophil count dropped to below 800/mm3 were given granulocyte colony stimulating factor (G-CSF) subcutaneously. The dose and frequency of erythropoietin and G-CSF were given according to our center local guidelines, which are similar to the international protocols.

Patients were followed up at the hepatology clinic every 2 wk for the first 6 wk and every 6-8 wk thereafter. Patients were also seen in the nephrology clinic every four to eight weeks. Immunosuppression All patients were on maintenance steroid therapy in the form of prednisone. Fifteen patients were on mycophenolate mofetil (CellCept), eight on cyclosporine and nine on tacrolimus. One patient received sirolimus. None of our patients received azathioprine. Ethical and safety issues Since there was no available international treatment protocol, the risks and benefits of therapy, including potential graft rejection were explained carefully to all patients by the nephrologists and further reinforced by the hepatologist before commencing therapy as normal precautions which were usually performed in similar conditions outside study protocols.

Only those patients who consented received the therapy. The study was passed by the hospital��s research committee and approved by the institutional review board. Statistical analysis The data was analyzed using SPSS version 17. Descriptive data was obtained for all the parameters tested (mean, median, SD). The change over time in liver profile, renal profile, and viral load were compared using ANOVA and changes between baseline and end of treatment parameters were examined using Carfilzomib paired t-test.