Similar Risk of Renal Events Among Patients Treated with Tenofovir or Entecavir

StephenW

Clin Gastroenterol Hepatol. 2012 Apr 13. [Epub ahead of print]
Similar Risk of Renal Events Among Patients Treated with Tenofovir or Entecavir for Chronic Hepatitis B.Gish RG, Clark MD, Kane SD, Shaw RE, Mangahas MF, Baqai S.
SourceUniversity of California at San Diego, San Diego, California, USA.

Abstract
BACKGROUND AND AIMS: Tenofovir is a nucleotide reverse-transcriptase inhibitor approved for treatment of HIV infection, as well as chronic hepatitis B (CHB). We evaluated nephrotoxicity among patients with CHB treated with tenofovir.
METHODS: We performed a community-based, retrospective cohort study of 80 patients with CHB who received tenofovir, alone or in a combination regimen; they were matched for age and sex with 80 CHB patients who received only entecavir. Incidences of serum creatinine (SCr) increase ≥ 0.2 mg/dL and new SCr levels of 1.5, 2.0, or 2.5 mg/dL were assessed. Patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min, calculated using the Modification of Diet in Renal Disease (MDRD) or Cockcroft-Gault (CG) formula, or who had ≥ 20% decrease in eGFR were also recorded.
RESULTS: More patients given entecavir had increases in SCr ≥ 2.5 mg/dL (1 vs 6; p = .053), whereas more patients given tenofovir had a new CG eGFR of < 60 mL/min (15 vs 6; P=.022) and at least one dose adjustment (13 vs 4; p =.021). By multivariate analysis, the only significant factors associated with an increase in SCr were a history of organ transplantation (adjusted odds ratio [OR] 6.740; 95% confidence interval [CI], 1.799 - 28.250; p =.005) and pre-existing renal insufficiency (adjusted OR 10.960; 95% CI, 2.419 - 48.850; p =.002). No factors, including therapy assignment, were associated with a new eGFR < 60 ml/min.
CONCLUSION: Markers of renal function indicated that patients who received tenofovir were no more likely to have changes in renal function than patients treated with entecavir. History of transplant and pre-existing renal insufficiency were the only factors independently associated with increases in SCr.

StephenW

临床胃肠肝胆病杂志。 2012年4月13日。 [出处提前打印]
类似的风险与替诺福韦或恩替卡韦治疗慢性乙型肝炎治疗的患者的肾脏事件
吉什的RG，克拉克博士，凯恩SD，肖RE，Mangahas MF，Baqai S.
源

美国加州大学，美国加利福尼亚州圣迭戈，圣迭戈。
抽象
背景与目的：

泰诺福韦是核苷酸逆转录酶抑制剂用于治疗艾滋病毒感染的批准，以及慢性乙型肝炎（CHB）。我们评估了替诺福韦治疗慢性乙型肝炎患者的肾毒性。
方法：

我们进行了80例慢性乙型肝炎患者接受替诺福韦，单独或组合方案以社区为基础，回顾性队列研究，他们分别为80只替卡韦的慢性乙型肝炎患者的年龄和性别相匹配。血清肌酐（SCr）增加≥0.2 mg / dL和新肌酐水平1.5，2.0，或2.5毫克/升的发病率进行了评估。患者估计肾小球滤过率（eGFR）<60毫升/分钟计算，使用改性饮食肾脏病（MDRD）或克罗夫特，高尔特（CG）公式，或者谁了的eGFR下降≥20％，也记录。
结果：

更给予恩替卡韦的患者在SCr增加≥2.5毫克/升（1比6，P = 0.053），而给予泰诺福韦更多的患者有一个新的企业管治的eGFR <60毫升/分（15比6，P = 0.022）并且至少有一个调整剂量（13比4，P = .021）。多因素分析，与SCr增加相关的唯一重要因素是器官移植的历史（调整后胜算比[OR]为6.740; 95％信心区间[CI]，1.799  -  28.250，P = 0.005）和预先存在的肾功能不全（调整OR 10.960; 95％CI，2.419  -  48.850，P = 0.002）。任何因素，包括治疗任务，是一个新的eGFR <60毫升/分钟。
结论：

肾功能指标表明，接受替诺福韦的患者更可能有比用恩替卡韦治疗的患者的肾功能变化。历史上的移植和预先存在肾功能不全肌酐增加独立相关的唯一因素。