Medicine (Baltimore). 2018 Feb;97(7):e9756. doi: 10.1097/MD.0000000000009756.
Effect of tenofovir on renal function in patients with chronic hepatitis B.Jung WJ1, Jang JY1, Park WY1, Jeong SW1, Lee HJ1, Park SJ1, Lee SH2, Kim SG3, Cha SW1, Kim YS3, Cho YD1, Kim HS2, Kim BS1, Park S4, Baymbajav B5. Author information 1Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul.2Department of Internal Medicine, College of Medicine, Soonchunhyang University, Cheonan.3Department of Internal Medicine, College of Medicine, Soonchunhyang University, Bucheon.4Biostatistical Consulting Unit, Soonchunhyang University, Seoul, Korea.5UB Songdo Hospital, Ulaanbaatar, Mongolia.
AbstractTenofovir disoproxil fumarate (TDF) is widely used to treat patients with hepatitis B virus (HBV) infection. We investigated the effect of TDF on renal insufficiency in patients with chronic hepatitis B (CHB).A consecutive cohort analysis was applied to CHB patients taking prescribed TDF from January 2012 to May 2016 at Soonchunhyang University Seoul Hospital. Alterations over time in corrected calcium, phosphate, creatinine, and estimated glomerular filtration rate (eGFR) were analyzed using the generalized estimating equation method. The percentage increase in creatinine from baseline to the maximum creatinine level (delta creatinine) was compared according to the underlying disease using the Mann-Whitney U test. Cox proportional hazard regression model was used to determine risk factors associated with renal insufficiency.The baseline creatinine, eGFR, corrected calcium, and phosphate levels were 0.72 ± 0.01 mg/dL (mean ± SD), 106.37 ± 1.06 mL/min/1.73 m, 8.82 ± 0.04 mg/dL, and 3.42 ± 0.05 mg/dL, respectively. The creatinine level had increased significantly at 12, 24, 48, 72, and 96 weeks, while the eGFR level had decreased significantly at these 5 time points. Multivariate analysis confirmed that age ≥60 years and the baseline bilirubin level were independently associated with the risk of renal insufficiency. Delta creatinine was significantly higher in patients with diabetes mellitus (DM) than in patients without DM.Renal function was decreased from baseline in CHB patients receiving TDF therapy, which indicates that the renal function of patients undergoing treatment with TDF should be monitored regularly. Old age, DM, and serum bilirubin were risk factors for the development of renal insufficiency in CHB patients receiving TDF therapy.