Effects of Entecavir and Tenofovir on Renal Function in Patients with Hepatitis B Virus-Related Compensated and Decompensated Cirrhosis.
Effects of Entecavir and Tenofovir on Renal Function in Patients with Hepatitis B Virus-Related Compensated and Decompensated Cirrhosis.
复制标题
DOI：
10.5009/gnl16484
复制
发表时间：
2017-11-15
期刊：
影响因子：
3.4
通讯作者：
Park JY
中科院分区：
文献类型：
--
作者：
Park J;Jung KS;Lee HW;Kim BK;Kim SU;Kim DY;Ahn SH;Han KH;Park JY
核苷（酸）类似物对慢性B型肝炎患者肾脏的影响存在争议。我们的目的是比较恩替卡韦（ETV）和替诺福韦（TDF）对B型肝炎病毒（HBV）相关肝硬化患者肾功能的影响。我们对2012年12月至2013年11月期间在韩国首尔Severance医院接受ETV或TDF治疗的235例连续HBV相关肝硬化初治患者进行了回顾性队列研究。代偿性肝硬化183例（ETV 130例，TDF 53例），失代偿性肝硬化52例（ETV 32例，TDF 20例）。第96周，ETV或TDF治疗组的估计肾小球滤过率（eGFR）较基线均无显著变化（慢性肾脏病流行病学协作组，ETV −1.68%和TDF − 5.03%，p=0.358）。使用多变量分析，与eGFR降低>20%相关的显著因素是基线eGFR、糖尿病（DM）和使用利尿剂。抗病毒药物的使用和基线失代偿未被确定为显著因素。在HBV相关肝硬化患者中，TDF在2年内显示出与ETV相似的肾脏安全性。应密切监测肾功能，尤其是eGFR降低、DM和使用利尿剂的患者。
The renal effects of nucleos(t)ide analogs in patients with chronic hepatitis B are controversial. We aimed to compare the impact of entecavir (ETV) and tenofovir (TDF) on renal function in patients with hepatitis B virus (HBV)-related cirrhosis. We performed a retrospective cohort study of 235 consecutive treatment-naïve patients with HBV-related cirrhosis who were treated with ETV or TDF between December 2012 and November 2013 at Severance Hospital, Seoul, Korea. Compensated cirrhosis was noted in 183 patients (ETV 130, TDF 53), and decompensated cirrhosis was noted in 52 patients (ETV 32, TDF 20). There were no significant changes in estimated glomerular filtration rates (eGFR) from baseline in either the ETV- or TDF-treated groups at week 96 (Chronic Kidney Disease Epidemiology Collaboration, ETV −1.68% and TDF −5.03%, p=0.358). Using a multivariate analysis, the significant factors associated with a decrease in eGFR >20% were baseline eGFR, diabetes mellitus (DM), and the use of diuretics. The use of antiviral agents and baseline decompensation were not determined to be significant factors. In patients with HBV-related cirrhosis, TDF has shown similar renal safety to that of ETV over a 2-year period. Renal function should be closely monitored, especially in patients who exhibit decreasing eGFR, DM, and the use of diuretics.
登录
查看更多内容
影响因子：
8.9
作者：
Korean Association for the Study of the Liver
通讯作者：
Korean Association for the Study of the Liver
影响因子：
3.4
作者：
Lee S;Park JY;Song K;Kim DY;Kim BK;Kim SU;Ku HJ;Han KH;Ahn SH
通讯作者：
Ahn SH
影响因子：
8.9
作者：
Ahn, Sung Soo;Chon, Young Eun;Park, Jun Yong
通讯作者：
Park, Jun Yong
影响因子：
13.5
作者：
Hwang, Hyeon Seok;Park, Cheol Whee;Song, Myeong Jun
通讯作者：
Song, Myeong Jun
慢性乙型肝炎的长期adefovir或Tenofovir疗法期间的肾小管功能障碍。
影响因子：
7.6
作者：
Gara N;Zhao X;Collins MT;Chong WH;Kleiner DE;Jake Liang T;Ghany MG;Hoofnagle JH
通讯作者：
Hoofnagle JH