Comparison of the Effects of Telbivudine and Entecavir Treatment on Estimated Glomerular Filtration Rate in Patients with Chronic Hepatitis B.
Comparison of the Effects of Telbivudine and Entecavir Treatment on Estimated Glomerular Filtration Rate in Patients with Chronic Hepatitis B.
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DOI：
10.5009/gnl14297
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发表时间：
2015-11-23
期刊：
影响因子：
3.4
通讯作者：
Ahn SH
中科院分区：
文献类型：
--
作者：
Lee S;Park JY;Song K;Kim DY;Kim BK;Kim SU;Ku HJ;Han KH;Ahn SH
本研究的目的是评估慢性乙型肝炎（CHB）患者在替比夫定（LdT）和恩替卡韦（ETV）治疗期间估计的肾小球滤过率（eGFR），这些慢性乙型肝炎（CHB）患者有潜在的合并症，如糖尿病（DM）、高血压和肝硬化。从2010年到2012年，116名接受LdT治疗的CHB患者和578名接受ETV治疗的CHB患者进行了比较。使用线性混合模型分析从基线到6、12和18个月的eGFR（肾脏疾病饮食改变[MDRD]公式）的平均变化。在接受ldt治疗的患者中，与基线eGFR相比，第18个月的平均eGFR增加了7.6% （MDRD公式为mL/min/1.73 m2）。然而，在接受etv治疗的患者中，与基线时相比，18个月时的平均eGFR下降了4.1%。在接受ldt治疗的糖尿病、高血压、肝硬化或eGFR低于90 mL/min/1.73 m2的患者中，平均eGFR稳步改善，而在接受etv治疗的同一亚组患者中，平均eGFR下降。在LdT治疗期间，eGFR随着时间的推移逐渐升高，尤其是基线时eGFR轻度异常的患者，以及糖尿病、高血压和肝硬化患者，而ETV治疗时eGFR有所降低。
The aim of this study was to evaluate the estimated glomerular filtration rate (eGFR) during telbivudine (LdT) versus entecavir (ETV) treatment in chronic hepatitis B (CHB) patients with underlying comorbidities such as diabetes mellitus (DM), hypertension, and cirrhosis. From 2010 to 2012, 116 CHB patients treated with LdT and 578 treated with ETV were compared in this real-practice cohort. The mean changes in eGFR (Modification of Diet in Renal Disease [MDRD] formula) from baseline to months 6, 12, and 18 were analyzed using a linear mixed model. In LdT-treated patients, the mean eGFR increased by 7.6% at month 18 compared with the eGFR at baseline (MDRD formula in mL/min/1.73 m2). However, in ETV-treated patients, the mean eGFR decreased by 4.1% at month 18 compared with the eGFR at baseline. In the LdT-treated patients with DM, hypertension, cirrhosis or low eGFR <90 mL/min/1.73 m2, the mean eGFR showed a steady improvement, whereas the mean eGFR was reduced in the same subgroups of ETV-treated patients. The eGFR gradually increased over time during LdT treatment, especially in patients with mild abnormal eGFR at baseline, and in those with DM, hypertension, and cirrhosis, whereas a reduction in eGFR was seen with ETV treatment.