Chronic kidney disease progression in patients with chronic hepatitis B on tenofovir, entecavir, or no treatment
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AbstractBackground
In clinical trials involving patients with preserved renal function, tenofovir disoproxil fumarate (TDF) use was associated with mild renal impairment in 1% of patients.

Aim
To compare serial renal function of entecavir (ETV)‐treated, TDF‐treated, and untreated patients with chronic hepatitis B.

Methods
We studied the risk of chronic kidney disease (CKD) progression in a territory‐wide cohort of patients with chronic hepatitis B without treatment and of those on ETV or TDF treatment. Estimated glomerular filtration rate (eGFR) was determined by the CKD Epidemiology Collaboration equation and was classified into five CKD stages. CKD progression, defined as an increase of at least one CKD stage, was compared among treated and untreated patients.

Results
After propensity score matching, 2254 ETV‐treated, 2254 TDF‐treated, and 2254 untreated patients were included in the analysis. Their mean baseline eGFR was 90.3 ± 19.6, 91.3 ± 20.6, and 92.2 ± 20.0 mL/min/1.73 m2, respectively. During a mean follow‐up of 2.4 ± 1.5 years, 639 ETV‐treated, 706 TDF‐treated, and 564 untreated patients exhibited CKD progression ≥1 stage. The 5‐year cumulative incidence (95% confidence interval) of CKD progression was 43% (40%‐46%) in ETV‐treated, 48% (45%‐51%) in TDF‐treated, and 43% (39%‐47%) in untreated patients (reference group), respectively (P = 0.267 and <0.001, respectively). The number of patients who exhibited CKD progression ≥2 stages was 92 (4.1%) in the untreated cohort, 95 (4.2%) in the ETV‐treated cohort, and 51 (2.3%) in the TDF‐treated cohort.

Conclusions
The use of TDF was associated with mild renal impairment in a minority of patients; those treated with ETV had a similar risk compared to untreated patients.
All Author(s) ListWong GLH, Chan HLY, Tse YK, Yip TCF, Lam KLY, Lui GCY, Szeto CC, Wong VWS
Journal nameAlimentary Pharmacology and Therapeutics
Year2018
Month11
Volume Number48
Issue Number9
PublisherWILEY
Pages984 - 992
ISSN0269-2813
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesGastroenterology & Hepatology;Pharmacology & Pharmacy;Gastroenterology & Hepatology;Pharmacology & Pharmacy

Last updated on 2020-22-09 at 03:58