长期阿德福治疗慢性乙肝炎患者-肾功能损害的频率和风险因

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06852.x/abstract;jsessionid=039C258033F0DACD407C0B04114293B1.d02t02>
肾功能损害的频率和风险因素在长期阿德福韦
酯治疗慢性乙型肝炎患者



Frequency and Risk Factors of Renal Impairment During Long-term Adefovir
Dipivoxil Treatment in Chronic Hepatitis B Patients

Yu Jin Kim, Hyun Chin Cho, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi,
Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo, Joon Hyeok Lee

DOI: 10.1111/j.1440-1746.2011.06852.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell
Publishing Asia Pty Ltd Issue

Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)

Abstract

Background and Aim

There is insufficient data on renal safety during long-term adefovir
dipivoxil (ADV) treatment. We aimed to elucidate the incidence and risk
factors of renal impairment in chronic hepatitis B (CHB) patients treated
with ADV.

Methods

We retrospectively enrolled 687 CHB patients (51.4% with compensated
cirrhosis) treated with ADV alone (18.2%) or in combination with lamivudine
(LAM, 81.8%) for more than 12 months. Renal function was measured using
estimated glomerular filtration rate (eGFR), and renal dysfunction was
defined as mild (20-30% decrease), moderate (30-50%), or severe (more than
50%).

Results

During the median treatment duration of 27 months, 72 patients (10.5%)
developed renal impairment, which was mild in 77.8% of cases, moderate in
20.8% of cases, and severe in one patient. The cumulative incidence of
renal impairment at 1, 3, and 5 years was 2.6%, 14.8%, and 34.7%,
respectively. Modification of the dosing interval or discontinuation of ADV
was required in seven and three patients, respectively, and none of them
showed further decline of eGFR. Although univariate analysis revealed age,
the number of exposure to radio-contrast dye, liver cirrhosis, and
hepatocellular carcinoma as risk factors of renal impairment, age was the
only significant risk factor identified in multivariate analysis [ odds
ratio = 1.048, 95% confidence interval = 1.019–1.076, p= 0.001).

Conclusions

Renal impairment in long-term ADV users was relatively frequent, but
serious renal toxicity was rare and all cases were safely managed. Careful
monitoring of renal function is required, especially in older patients.

StephenW

谷歌翻译
不是100％准确，仅供参考使用。


肾功能损害的频率和风险因素在长期阿德福韦
酯治疗慢性乙型肝炎患者

毓瑾金，玄琴赵，董玄新芬，今，郭妍，月亮石财，
光澈苏梅，承焕白南准，秉哲柳，李俊赫

DOI：10.1111/j.1440-1746.2011.06852.x

© 2011年杂志胃肠病学和肝病基金会和Blackwell
出版亚洲私人有限公司发行

胃肠病学和肝病学杂志
接受第（接受，未来网上公布的未经编辑的文章
问题）

摘要

背景和目的

有肾安全的数据不足，在长期阿德福韦
酯（ADV）治疗。我们的目的是澄清的发病率和风险
在慢性乙型肝炎（CHB）患者治疗肾功能不全的因素
与ADV。

方法

我们追溯招收687例慢性乙型肝炎患者（51.4％与补偿
肝硬化）单用ADV（18.2％）或与拉米夫定联合治疗
（林，81.8％），超过12个月。肾功能测定采用
估计的肾小球滤过率（eGFR），和肾功能不全
（以上定义为轻度（减少20-30％），中度（30-50％），或严重
50％）。

结果

在27个月，72例（10.5％）的平均治疗时间
开发的肾功能不全，这在77.8％的病例是轻度，中度
20.8％的病例，1例严重。累积发病率

1，3年和5年肾功能不全是2.6％，14.8％和34.7％，
分别。给药间隔时间或停止ADV的修改
被要求在7 3例，分别与他们没有
显示表皮生长因子受体的进一步下降。虽然单因素分析显示年龄，
暴露于无线电造影剂，肝硬化，
肝癌，肾功能损害的危险因素，年龄
多变量分析中发现的唯一的重要危险因素[比值
比率= 1.048，95％可信区间= 1.019-1.076，P = 0.001）。

结论

在长期的ADV用户肾损害是比较频繁，但
严重的肾毒性是罕见的，所有病例均安全管理。小心
对肾功能的监测是必需的，尤其是中老年患者。