Background and Objectives: Hepatitis C virus (HCV) infection is a major global public health concern, particularly in hemodialysis (HD) patients. This study aims to evaluate the demographic, clinical, and laboratory characteristics of HCV-positive patients undergoing HD and assess the long-term impact of direct-acting antivirals (DAAs) on patient outcomes. Moreover, a narrative review aims to summarize the current knowledge regarding HCV treatment in HD patients. The search in the PubMed, Google Scholar, and Scopus databases identified 48 studies relevant to our topic, 18 regarding clinical history and 29 related to HCV treatment. Methods: A retrospective analysis was performed on 165 HD patients from Bihor County HD centers, Romania, between 2014 and 2024. The cohort was divided into two groups: 54 patients who tested positive for HCV and 111 controls who were HCV-negative. Data collected from GPs included demographic information, comorbidities, laboratory parameters, and psychological assessments. Outcomes were evaluated at over 5 years after DAA treatment. A literature review was conducted using PubMed and Google Scholar to identify relevant studies on HCV in HD patients from 1989 to 2024. Results: Laboratory results showed similar parameters across groups, except for lower serum cholesterol levels in the HCV-positive DAA-treated group vs. HCV-positive non-treated ones (155.607 mg% vs. 170.174 mg%, p = 0.040) and increased ALT levels when comparing the same groups (29.107 vs. 22.261, p = 0.027), whereas comorbidities did not differ significantly. The incidence of malignancies was significantly higher among HCV-positive compared to HCV-negative patients (20.3% vs. 8.1%, p = 0.023), mainly among those treated with DAAs, highlighted by the multivariate analysis. Cardiovascular disease remains the leading cause of mortality regardless of HCV status or the use of antiviral therapy. Psychological assessments revealed more severe depression in HCV-positive patients compared to their HCV-negative counterparts. Conclusions: HCV infection in the hemodialysis population typically follows a subclinical course. At over five years after DAA therapy, the results indicate a stabilization of the liver function and the absence of major complications. However, the incidence of malignancies remains high in HCV-positive patients.

Background/Objectives: Magnesium plays a crucial role in immune function, influencing immunoglobulin synthesis, antibody-dependent cytolysis, and other immune processes. In renal transplant patients, magnesium deficiency is primarily induced by calcineurin inhibitor treatment, through the reduction of magnesium transporter proteins in the renal tubules, leading to magnesium loss. Methods: To assess the correlation between serum magnesium levels and the long-term outcomes of renal graft and transplant recipients, we conducted a retrospective study on 87 patients who have had a transplant for more than 5 years, a period considered immunologically stable. We evaluated laboratory parameters such as glycemia, creatinine, total protein, and C-reactive protein (CRP), as well as demographic data, primary kidney disease, donor type, comorbidities, and infection incidence. Results: This study revealed clinical stability at over 5 years post-transplantation, with no significant differences between the 5–15 and over-15-years groups with regard to major comorbidities, except for HCV infection (p = 0.018). Reduced magnesium levels were associated with impaired renal function (p = 0.017) and inflammatory syndrome (p = 0.012). Viral infections were correlated with living donor grafts (p = 0.05), hypoproteinemia, and decreased eGFR (estimated glomerular filtration rate), while bacterial infections, namely urinary tract infections (UTIs), were linked to reduced eGFR (p = 0.05, p = 0.046). Female patients with hypomagnesemia had a higher incidence of recurrent UTIs (p = 0.03). Conclusions: Hypomagnesemia correlates with increased infection risk in patients who received a renal transplant more than 5 years ago but does not significantly impact glycemic control or cardiovascular health.

Background: Hemodialysis (HD) patients are a highly vulnerable population with elevated mortality driven by comorbidities and dialysis-specific factors. While most studies focused on intra-pandemic outcomes, long-term effects remain underexplored. We aimed to evaluate 5-year mortality and the impact of COVID-19 vaccination in chronic HD patients. Methods: A retrospective study was conducted on 211 HD patients monitored between 2020 and 2024. Outcomes included overall and cardiovascular mortality, risk factors in COVID-19-positive patients, and vaccination impact. Logistic regression identified independent predictors. Results: The cohort had a mean age of 65.6 ± 13.3 years, with 55.9% males and mean dialysis vintage of 6.9 ± 5.5 years. Overall mortality reached 53.6%, while 38.4% were vaccinated. Predictors of all-cause mortality included age (OR = 1.078, p < 0.001), BMI (OR = 0.868, p < 0.001), hemoglobin (OR = 0.581, p < 0.001), phosphorus (OR = 1.351, p = 0.025), dialysis adequacy (OR = 0.138, p = 0.013), and ischemic cardiopathy (OR = 0.327, p = 0.009). In COVID-19-positive patients, mortality was associated with age (OR = 1.069, p = 0.002), low hemoglobin (OR = 0.642, p = 0.014), BMI (OR = 0.885, p = 0.009), CRP (OR = 1.015, p < 0.001), and coronary artery disease (OR = 5.68, p < 0.001). Cardiovascular disease was the leading cause of death (44.6% in COVID-19-positive vs. 73.3% in negatives, p = 0.006). Vaccination significantly reduced COVID-19-related mortality (OR = 0.023, p = 0.005) but did not influence overall or non-COVID mortality. Conclusions: Five-year mortality in HD patients remained high, mainly cardiovascular, and was strongly influenced by age, BMI, hemoglobin, dialysis adequacy, and comorbidities. COVID-19 vaccination substantially reduced COVID-related mortality but did not alter all-cause outcomes. These findings support vaccination and careful risk stratification in HD populations for future pandemics.