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Renal dysfunction during treatment of chronic hepatitis B with tenofovir disoproxyl fumarate and associated risk factors

Maciel, Alessandra M de A ; Ferraz, Maria Lucia C G ; Perez, Renata de M ; Brandão-Mello, Carlos Eduardo

European journal of gastroenterology & hepatology, 2024-04, Vol.36 (4), p.482-488 [Periódico revisado por pares]

England

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  • Título:
    Renal dysfunction during treatment of chronic hepatitis B with tenofovir disoproxyl fumarate and associated risk factors
  • Autor: Maciel, Alessandra M de A ; Ferraz, Maria Lucia C G ; Perez, Renata de M ; Brandão-Mello, Carlos Eduardo
  • Assuntos: Adult ; Albumins - therapeutic use ; Antiviral Agents - adverse effects ; Creatinine ; Female ; Hepatitis B - complications ; Hepatitis B virus ; Hepatitis B, Chronic - complications ; Hepatitis B, Chronic - diagnosis ; Hepatitis B, Chronic - drug therapy ; Humans ; Hypertension - drug therapy ; Kidney Diseases ; Lipocalin-2 ; Male ; Middle Aged ; Phosphates - therapeutic use ; Retrospective Studies ; Risk Factors ; Tenofovir - adverse effects ; Treatment Outcome
  • É parte de: European journal of gastroenterology & hepatology, 2024-04, Vol.36 (4), p.482-488
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
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  • Descrição: To analyze the evolution of glomerular filtration rate (GFR) and the presence of renal tubular dysfunction during the treatment of chronic hepatitis B virus (HBV) infection with tenofovir disoproxil fumarate (TDF) and to determine the risk factors involved. Retrospective cohort observational study of adults with chronic hepatitis B. Exclusion: hepatitis C virus-HBV coinfection, diabetes, baseline GFR less than 60 ml/min. Measurements of serum and urinary creatinine and phosphate; urinary albumin, retinol-binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) were performed. Univariate and multivariate analyses tracked factors associated with worsening GFR. A total of 120 individuals were included: 35% NAÏVE (G1); 49.2% HBV using TDF (G2); 15.8% HBV-HIV using TDF (G3); 63.3% men; 60.8% white; 30% hypertensive. Average age was 50.5 years (SD ± 12.9 years). Reactive HBeAg predominated in G3 ( P  < 0.001) and cirrhosis in G2 ( P  < 0.036). NGAL was elevated in 5.3% of cases (G1 = 3.2%; G2 = 8.7%; G3 = 0%; P  = 0.582), RBP in 6.7% (G1, G3 = 0%; G2 = 13.6%; P  = 0.012), urinary phosphate/creatinine ratio in 16.2% (G1 = 15.2%; G2 = 14.5%; G3 = 23.5%; P  = 0.842) and urinary albumin/creatinine ratio in 12.9% (G1 = 12.2%; G2 = 10.7%; G3 = 21.1%; P  = 0.494). Worsening of renal function occurred in 22.5% of the population (G1 = 11.9%; G2 = 28.8%; G3 = 26.3%; P  = 0.122), independently associated only with systemic arterial hypertension [adjusted odds ratio (AOR) = 4.14; P  = 0.008], but not to TDF (AOR = 2.66; P  = 0.110) or male sex (AOR = 2.39; P  = 0.135). However, the concomitance of these variables generated a high estimated risk for this outcome (51%). Renal tubular dysfunction was uncommon according to NGAL, RBP or urinary phosphate/creatinine ratio. TDF was not an independent factor for worsening renal function, significantly associated only with systemic arterial hypertension. However, in hypertensive men, the use of TDF should be monitored.
  • Editor: England
  • Idioma: Inglês
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