Quadruple Nephropathy in a Liver Transplant Patient

Hepatitis C Virus (HCV) is associated with multiple renal diseases, namely cryoglobulinemic Membranoproliferative Glomerulonephritis (MPGN), IgA nephropathy, and diabetic nephropathy. The pattern of renal injury in patients with HCV-associated cryoglobulinemia is MPGN in nearly 80% of cases. The pathogenesis linking IgA nephropathy with HCV and cirrhosis remains unclear. HCV is associated with an increased risk of type 2 diabetes mellitus. Cirrhotic patients are at risk for Acute Tubular Necrosis (ATN) due to a tenuous hemodynamic state. We describe a case of quadruple nephropathy in a patient with HCV and diabetes mellitus who develops MPGN, IgA nephropathy, diabetic nephropathy and ATN.