中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 8
Aug.  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(8): 1798-1801

Influencing factors for abnormal renal function markers in chronic hepatitis B patients receiving long-term oral administration of entecavir/tenofovir disoproxil fumarate

DOI: 10.3969/j.issn.1001-5256.2021.08.011

  • Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou 450000, China

Research funding:

National Key R&D Program of China (2018ZX10302205-004)

  • Received Date: 2020-12-24
  • Accepted Date: 2021-01-26
  • Published Date: 2021-08-20
    Abstract
  •   Objective  To investigate the status of abnormal renal function markers and related influencing factors in chronic hepatitis B (CHB) patients receiving oral antiviral drugs for a long time.  Methods  A retrospective analysis was performed for the clinical data of 681 CHB patients who attended Henan Provincial People's Hospital from January to December 2019 and received long-term oral administration of entecavir (ETV)/tenofovir disoproxil fumarate (TDF). All patients received the measurement of blood renal function markers (urea, creatinine, retinol-binding protein [RBP], cystatin C [Cys-C], and β2-microglobulin [β2-MG]), urinary renal function markers (α1-microglobulin [α1-MG], Cys-C, and N-acetyl-β-D-glucosaminidase [NAG]), and urine routine parameters. The incidence rate of abnormal renal function markers were analyzed. The McNemar's test was used for comparison of categorical data between groups, and the multivariate logistic regression analysis was used to investigate independent influencing factors for abnormal renal markers in urine.  Results  The 681 patients had a mean age of 39.8±11.0 years and received medication for 1.88 (0.80-3.16) years. There were 417 male patients and 264 female patients, and the incidence rate of liver cirrhosis was 27.02% (184/681). Of all 681 patients, 442 received ETV and 239 received TDF. The measurement of blood renal function markers showed that urea, creatinine, retinol-binding protein, Cys-C, and β2-MG had an abnormal rate of 6.9% (47/681), 0.15% (1/681), 0(0/681), 2.21% (15/681), and 5.03% (30/681), respectively, and the abnormal rate of urinary protein was 7.29% (49/672). The measurement of urinary renal function markers showed that α1-MG, NAG, and Cys-C had an abnormal rate of 38.62% (263/681), 37.74% (257/681), and 19.38% (132/681), respectively. The abnormal rate of urine test was higher than that of blood test (P < 0.001). The multivariate logistic regression analysis with urinary α1-MG as the dependent variable showed that sex (odds ratio [OR]=0.293, 95% confidence interval [CI]: 0.204-0.419, P < 0.05), age (OR=1.298, 95%CI: 1.108-1.521, P < 0.05), and type of nucleoside drug (OR=2.100, 95%CI: 1.431-3.083, P < 0.05) were influencing factors. The multivariate logistic regression analysis with urinary NAG as the dependent variable showed that age (OR=1.177, 95%CI: 1.008-1.375, P=0.040) was an influencing factor.  Conclusion  Compared with blood renal function markers, urinary renal function markers can identify renal injury earlier in CHB patients, and the elderly patients and the patients receiving TDF are more likely to develop abnormal renal function. However, it is not observed whether the duration of medication and liver cirrhosis can increase the risk of renal injury in CHB patients.

     

    • FullText(HTML)
  • loading
    • References(12)
  • [1]
    Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseaes, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B: A 2015 update[J]. Chin J Hepatol, 2015, 31(12): 1941-1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12): 1941-1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.
    [2]
    ZHAO Y, LI Y, QI L, et al. Antiviral curative effects of tenofovir and entecavir in treatment of aged patients with chronic hepatitis B and their regulation on inflammation factors[J]. J Jilin Univ(Med Edit), 2019, 45(1): 117-122. DOI: 10.13481/j.1671-587x.20190122.

    赵阳, 李烨, 齐玲, 等. 替诺福韦酯和恩替卡韦治疗老年慢性乙型肝炎患者的抗病毒疗效及对致炎细胞因子的调节作用[J]. 吉林大学学报(医学版), 2019, 45(1): 117-122. DOI: 10.13481/j.1671-587x.20190122.
    [3]
    GUPTA SK, POST FA, ARRIBAS JR, et al. Renal safety of tenofovir alafenamide vs. tenofovir disoproxil fumarate: A pooled analysis of 26 clinical trials[J]. AIDS, 2019, 33(9): 1455-1465. DOI: 10.1097/QAD.0000000000002223.
    [4]
    TERRAULT NA, LOK ASF, MCMAHON BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67(4): 1560-1599. DOI: 10.1002/hep.29800.
    [5]
    European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. DOI: 10.1016/j.jhep.2017.03.021.
    [6]
    World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection[EB/OL]. https://apps.who.int/iris/handle/10665/154590.
    [7]
    CHEN YC, SU YC, LI CY, et al. 13-year nationwide cohort study of chronic kidney disease risk among treatment-naïve patients with chronic hepatitis B in Taiwan[J]. BMC Nephrol, 2015, 16: 110. DOI: 10.1186/s12882-015-0106-5.
    [8]
    UDOMPAP P, KIM D, AHMED A, et al. Longitudinal trends in renal function in chronic hepatitis B patients receiving oral antiviral treatment[J]. Aliment Pharmacol Ther, 2018, 48(11-12): 1282-1289. DOI: 10.1111/apt.15020.
    [9]
    WONG GL, CHAN HL, TSE YK, et al. Chronic kidney disease progression in patients with chronic hepatitis B on tenofovir, entecavir, or no treatment[J]. Aliment Pharmacol Ther, 2018, 48(9): 984-992. DOI: 10.1111/apt.14945.
    [10]
    Chinese Society of Hepatology, Chinese Medical Association. Expert consensus on antiviral therapy for chronic hepatitis B with renal injury or high risk of renal injury[J]. J Clin Hepatol, 2016, 32(12): 2242-2247. DOI: 10.3969/j.issn.1001-5256.2016.12.004.

    中华医学会肝病学分会. 伴有肾脏损伤及其高危风险的慢性乙型肝炎患者抗病毒治疗专家共识[J]. 临床肝胆病杂志, 2016, 32(12): 2242-2247. DOI: 10.3969/j.issn.1001-5256.2016.12.004.
    [11]
    XIE XA. Evaluation of several methods for detecting renal tubular function[J]. Chin J Pract Pediatr, 2003, 18(8): 451-454. DOI: 10.3969/j.issn.1005-2224.2003.08.002.

    谢祥鳌. 几种检测肾小管功能的方法及评价[J]. 中国实用儿科杂志, 2003, 18(8): 451-454. DOI: 10.3969/j.issn.1005-2224.2003.08.002.
    [12]
    SRIPRAYOON T, MAHIDOL C, UNGTRAKUL T, et al. Efficacy and safety of entecavir versus tenofovir treatment in chronic hepatitis B patients: A randomized controlled trial[J]. Hepatol Res, 2017, 47(3): e161-e168. DOI: 10.1111/hepr.12743.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (589) PDF downloads(98) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return