Comparison of tenofovir and entecavir in the development of acute kidney injury in cirrhotic chronic hepatitis B patients with refractory ascites
Tsai, Ming-Chaoa,,b; Chang, Kuo-China; Yen, Yi-Haoa; Wu, Cheng-Kuna; Lin, Ming-Tsunga; Hu, Tsung-HuiaAuthor Information
European Journal of Gastroenterology & Hepatology: February 2021 - Volume 32 - Issue 2 - p 208-213
doi: 10.1097/MEG.0000000000001711
Buy
Abstract
Background and aim:
Tenofovir disoproxil fumarate (TDF) and entecavir are effective antiviral medications that are recommended as first-line monotherapies for the treatment of chronic hepatitis B (CHB) infection, including decompensated liver cirrhosis with ascites. Acute kidney injury (AKI) commonly occurs in patients with cirrhosis and ascites. The aim of this study was to compare the development of AKI during TDF and entecavir treatment of CHB patients with cirrhotic refractory ascites.
Methods:
From January 2011 to April 2017, we identified patients who were diagnosed with cirrhosis with refractory ascites and received TDF or entecavir treatments at Kaohsiung Chang Gung Memorial Hospital. AKI was defined as an increase in serum creatinine of more than 0.3 mg/dL or 1.5-fold from baseline. All episodes of AKI were recorded and compared between those who received TDF and entecavir.
Results:
A total of 111 patients were enrolled in this retrospective study, of which 22 patients were treated with TDF and 89 were treated with entecavir. Patients with AKI episodes had a higher proportion of TDF treatment (P = 0.01), male (P = 0.023), hepatocellular carcinoma (P = 0.007), admission (P = 0.045), and mortality (P = 0.018). Logistic regression analysis illustrated that TDF treatment of patients with comorbidity was an independent risk factor for the development of AKI [odds ratio (OR), 3.756; 95% confidence interval (CI), 1.293–10.912; P = 0.015] and hepatorenal syndrome (OR, 7.651; 95% CI, 1.697–34.508; P = 0.008).
Conclusions: