Table 3.

Recommended Regimens for Patients With Chronic Kidney Disease

Recommendation	Genotype	Duration (Weeks)	Rating
CKD stage 1, 2, and 3a	Follow standard direct-acting antiviral agents; treatment guidance
CKD stage 4 and 5b
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg)c	1a, 1b, 4	12	I, B
Daily coformulated 3-tablet combination of glecaprevir (300 mg)/pibrentasvir (120 mg)	1, 2, 3, 4, 5, 6	12	I, B

Abbreviations: CKD, chronic kidney disease; NS5A, nonstructural protein 5A.

^aCKD stages: 1 normal (estimated glomerular filtration rate [eGFR] >90 mL/min); 2 mild CKD (eGFR 60–89 mL/min); 3 moderate CKD (eGFR 30–59 mL/min).

^bCKD stages: 4 severe CKD (eGFR 15–29 mL/min); 5 end-stage CKD (eGFR <15 mL/min).

^cBaseline NS5A resistance-associated substitution (RAS) testing is recommended for genotype 1a prior to elbasvir/grazoprevir therapy; if NS5A RASs at positions 28, 30, 31, and/or 93 are identified, glecaprevir/pibrentasvir is recommended.