Chronic kidney disease progression in chronic hepatitis B patients receiving tenofovir disoproxil fumarate or entecavir: A territory-wide study
Refereed conference paper presented and published in conference proceedings



摘要Background: Previous studies showed that tenofovir disoproxil fumarate (TDF) use is associated with minor deterioration in renal function in a small proportion of patients, but the data are limited by small sample size and the exclusion of patients with existing chronic kidney disease (CKD). We studied the risk of CKD progression in a territory-wide cohort of patients with chronic hepatitis B (CHB) treated with TDF or entecavir (ETV).

Methods: All CHB patients who had received ETV or TDF from January 2005 to December 2016 were retrieved from the Clinical Data Analysis and Reporting System of the Hospital Authority, Hong Kong. Demographic data, comorbidities, serial creatinine, and other laboratory results were collected. Estimated glomerular filtration rate (eGFR) were determined by the CKD Epidemiology Collaboration equation, and classified into five CKD stages. The impact of ETV and TDF treatment on CKD progression, defined as an increase of at least one CKD stage, were compared.

Results: A total of 32, 091 ETV or TDF-treated CHB patients were identified; 29, 599 (92.2%) were first treated by ETV while 2,492 (7.8%) received TDF initially. During a median (interquartile range) follow-up of 22 (8-–50) months, 767 TDF-treated patients (30.8%) and 9,816 ETV-treated patients (33.2%) had CKD progression. The annual median (95% confidence interval [CI]) decline in eGFR were 1.66 (1.47–1.84) and 1.23 (1.18–1.28) ml/min/1.73 m2 in the TDF and ETV-treated patients, respectively (P = 0.007). TDF use as compared with ETV treatment (adjusted hazard ratio 1.23, 95% CI 1.14–1.33; P < 0.001), diabetes mellitus (1.20, 1.14–1.26; P < 0.001), and hypertension (1.28, 1.22–1.34; P < 0.001) were associated with increased risk of CKD progression after adjustment of age, sex, and baseline laboratory results.

Conclusion: TDF treatment in CHB patients is associated with higher risk of CKD progression than ETV treatment. Closer monitoring of renal function is recommended for CHB patients with diabetes mellitus or hypertension.
著者Yip TCF, Wong VWS, Tse YK, Wong GLH
會議名稱Asian Pacific Digestive Week (APDW) 2017
會議地點Hong Kong Convention and Exhibition Centre
會議論文集題名Journal of Gastroenterology and Hepatology
期次Suppl 3
頁次183 - 184
Web of Science 學科類別Gastroenterology & Hepatology;Gastroenterology & Hepatology

上次更新時間 2020-05-08 於 06:01