کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6106420 | 1211161 | 2011 | 6 صفحه PDF | دانلود رایگان |

Background & AimsTherapy of chronic hepatitis B with HBV-polymerase inhibitors, in particular tenofovir or adefovir, may affect renal function. To assess renal function more accurately in the normal range, we used the recently validated, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula to calculate the estimated glomerular filtration rate (eGFR).MethodsPatient subgroups included: patients with HBV-monoinfection treated with lamivudine (n = 36), adefovir (n = 32), entecavir (n = 32), or tenofovir (n = 37). HBsAg-positive untreated patients (n = 60) served as control. For comparison HIV-monoinfected patients treated with tenofovir (n = 120) or zidovudine (n = 52) based antiretroviral therapy and antiretroviral naive patients (n = 109) were assessed. CKD-EPI equation was used to calculate eGFR. In a more sensitive approach, we modeled the individual change in eGFR over time with linear mixed effects models (LME).ResultsYearly predicted median changes in individual eGFR according to the LME model were: HBV untreated â2.05 ml/min, HBV lamivudine â0.92 ml/min, HBV adefovir â1.02 ml/min, HBV entecavir â1.00 ml/min, and HBV tenofovir â0.92 ml/min (p <0.01 for HBV untreated vs. HBV treated). In HIV-monoinfected patients: HIV untreated â0.62 ml/min, HIV treated with tenofovir â2.64 ml/min, HIV treated with zidovudine â1.0 ml/min (p = 0.017 for tenofovir vs. no treatment, p <0.001 for tenofovir vs. zidovudine).ConclusionsTherapy of HBV infection irrespective of medication seems to result in a milder decrease of renal function. In contrast tenofovir as part of HIV combination therapy seems to impair renal function in this Caucasian population.
Journal: Journal of Hepatology - Volume 55, Issue 6, December 2011, Pages 1235-1240