الفهرس 
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Abstract
Introduction: HCV may also induce extrahepatic manifestations; including renal, hematological, musculoskeletal and dermatological disease. Studies reported that there was a strong and causal relationship between chronic HCV infection and glomerular disease. Several types of renal disease with HCV infection have been described including mixed cryoglobulinemia, membranoproliferative glomerulonephritis, membranous nephropathy and polyarteritis nodosa. Crescentic glomerulonephritis may be superimposed on any of these glomerular lesions. The aim of work: Determine the sustained virologic response in chronic HCV infected patients with HCV related nephropathy receiving direct acting antiviral drugs and to assess the immunological, clinical and renal responses to DAAs in this group of patients. Also, the current research aimed to investigate the safety of DAAs on the kidney and the occurrence of renal function changes. Research Plan: Patients diagnosed with chronic HCV infection (based on positive HCV serology and Rt-PCR HCV RNA) were enrolled into 2 groups: HCV nephropathy group: Presented by abnormalities in kidney function (raised serum creatinine and decline of eGFR) and/or proteinuria (more than 300 mg/day measured by 24hour urine collection) and/or active urinary sediments (RBCs, RBCs casts) and diagnosis was confirmed by renal biopsy (if accepted by the patient and not contraindicated) and/or abnormal serological markers (elevated RF and consumed C3 and C4). and other group chronic HCV without nephropathy Results: DAAs were effective as both nephropathic and non-nephropathic groups achieved excellent rates of viral clearance, in nephropathic patients, despite the high virological response; GFR, proteinuria and total renal responses were only achieved in nearly half of the patients in this group Conclusion: The use of DAAs was highly effective and tolerable, with high virological response rates in patients with or without HCV nephropathy, which was associated with amelioration of renal disease in half of the nephropathic patients. The occurrence of AKI with DAA regimens used in the study was independent of other AKI precipitating factors, transient and reversible after the end of treatment denoting renal safety of these drugs in patients with normal renal function.