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Early kidney injury during long-term adefovir dipivoxil therapy for chronic hepatitis B.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2015 Mar 28; Vol. 21 (12), pp. 3657-62. - Publication Year :
- 2015
-
Abstract
- Aim: To evaluate urine β2-microglobulin (β2-M), retinol-binding protein (RBP) excretion, and renal impairment with adefovir dipivoxil (ADV) for chronic hepatitis B.<br />Methods: We enrolled 165 patients with chronic hepatitis B infection who were treated with ADV monotherapy (n = 90) or ADV plus lamivudine combination therapy (n = 75). An additional 165 chronic hepatitis B patients treated with entecavir were recruited as controls. We detected serum creatinine, urine β2-M, and RBP levels, and estimated the glomerular filtration rate (eGFR) at the initiation of antiviral therapy and every 6 mo for a period of five years.<br />Results: Urine β2-M abnormalities were observed in patients during the first (n = 3), second (n = 7), third (n = 11), fourth (n = 16), and fifth (n = 21) year of ADV treatment. Urinary RBP abnormalities were observed in patients during the first (n = 2), second (n = 8), third (n = 12), fourth (n = 15), and fifth (n = 22) year of ADV treatment. eGFR decreased 20%-30% from baseline in 20 patients, 30%-50% in 12 patients, and > 50% in 3 patients during the five years of treatment. Further analysis indicated that decreases in eGFR of ≥ 30% relative to the baseline level correlated significantly with urine RBP and β2-M abnormalities. In contrast, both serum creatinine and eGFR remained stable in patients treated with entecavir, and only one of these patients developed a urine β2-M abnormality, and two developed urine RBP abnormalities during the five years of treatment.<br />Conclusion: Urine RBP and β2-M are biomarkers of renal injury during long-term ADV treatment for chronic hepatitis B, and indicate when treatment should be switched to entecavir.
- Subjects :
- Acute Kidney Injury diagnosis
Acute Kidney Injury physiopathology
Adenine administration & dosage
Adenine adverse effects
Adult
Antiviral Agents administration & dosage
Biomarkers blood
Biomarkers urine
Case-Control Studies
Creatinine blood
Drug Substitution
Female
Glomerular Filtration Rate
Guanine administration & dosage
Guanine analogs & derivatives
Hepatitis B, Chronic diagnosis
Humans
Male
Middle Aged
Organophosphonates administration & dosage
Predictive Value of Tests
Prospective Studies
Retinol-Binding Proteins urine
Risk Factors
Time Factors
Treatment Outcome
beta 2-Microglobulin urine
Acute Kidney Injury chemically induced
Adenine analogs & derivatives
Antiviral Agents adverse effects
Hepatitis B, Chronic drug therapy
Organophosphonates adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 21
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 25834334
- Full Text :
- https://doi.org/10.3748/wjg.v21.i12.3657