慢性乙型肝炎核苷类似物撤药后近端肾小管功能障碍的逆转

StephenW

Biomed Res Int. 2017;2017:4327385. doi: 10.1155/2017/4327385. Epub 2017 Oct 29.
Reversal of Proximal Renal Tubular Dysfunction after Nucleotide Analogue Withdrawal in Chronic Hepatitis B.
Sobhonslidsuk A1, Numthavaj P2, Wanichanuwat J1, Sophonsritsuk A3, Petraksa S1, Pugasub A4, Jittorntam P4, Kongsomgan A5, Roytrakul S6, Phakdeekitcharoen B7.
Author information
Abstract
Aims:

Proximal renal tubular dysfunction (PRTD) is an infrequent complication after nucleotide analogue therapy. We evaluated the outcomes of PRTD and nephrotoxicity after nucleotide analogue withdrawal in chronic hepatitis B (CHB).
Methods:

A longitudinal follow-up study was performed in patients with PRTD after nucleotide analogue discontinuation. Serum and urine were collected at baseline and every 3 months for one year. The fractional excretion of phosphate (PO4), uric acid (UA), and potassium and tubular maximal reabsorption rate of PO4 to glomerular filtration rate (TmPO4/GFR) were calculated. Renal losses were defined based on the criteria of substance losses. Subclinical PRTD and overt PRTD were diagnosed when 2 and ≥3 criteria were identified.
Results:

Eight subclinical and eight overt PRTD patients were enrolled. After nucleotide analogue withdrawal, there were overall improvements in GFR, serum PO4, and UA. Renal loss of PO4, UA, protein, and β2-microglobulin reduced over time. At one year, complete reversal of PRTD was seen in 13 patients (81.2%). Improvements in PRTD were seen in all but one patient.
Conclusion:

One year after nucleotide analogue withdrawal, PRTD was resolved in most patients. Changes in TmPO4/GFR, urinary protein, and β2-microglobulin indicate that urinary biomarkers may represent an early sign of PRTD recovery.

StephenW

Biomed Res Int。 2017; 2017：4327385。 doi：10.1155 / 2017/4327385。电子书2017年10月29日。
慢性乙型肝炎核苷类似物撤药后近端肾小管功能障碍的逆转
Sobhonslidsuk A1，Numthavaj P2，Wanichanuwat J1，Sophonsritsuk A3，Petraksa S1，Pugasub A4，Jittorntam P4，Kongsomgan A5，Roytrakul S6，Phakdeekitcharoen B7。
作者信息
抽象
目的：

近端肾小管功能障碍（PRTD）是核苷酸类似物治疗后罕见的并发症。我们评估慢性乙型肝炎（CHB）中核苷类似物停药后PRTD和肾毒性的结果。
方法：

在核苷酸类似物中断后，对PRTD患者进行纵向随访研究。在基线和每3个月收集血清和尿液一年。计算磷酸盐（PO4），尿酸（UA）的分数排泄量和PO4对肾小球滤过率（TmPO4 / GFR）的最大重吸收率。根据物质损失的标准确定了肾功能损失。亚临床PRTD和明显PRTD诊断时，确定2和≥3标准。
结果：

八个亚临床和八个明显PRTD患者入选。核苷酸类似物停药后，GFR，血清PO4和UA总体上有改善。随着时间的推移，PO4，UA，蛋白质和β2-微球蛋白的肾损失减少。 1年时，13例患者PRTD完全逆转（81.2％）。在所有的病人中都看到了PRTD的改善。
结论：

在核苷酸类似物撤销一年后，大多数患者中的PRTD得到了解决。 TmPO4 / GFR，尿蛋白和β2-微球蛋白的变化表明尿生物标志物可能代表PRTD恢复的早期征兆。

StephenW

https://www.hindawi.com/journals/bmri/2017/4327385/

windu

不错的研究

antiHBVren

赞！即，绝大部分因抗病毒而引起的肾损伤，在停药后可以恢复。

有亿

问题是什么时候能停药？

StephenW

回复 有亿 的帖子

停核苷酸(nucleotide), 换到核苷(nucleoside)抗病毒药物.