Bone and kidney toxicity induced by nucleotide analogues in patients affected by HBV-related chronic hepatitis: a longitudinal study

Abstract

In conclusion, patients exposed to lamivudine plus adefovir showed relevant osteorenal damage. The switch to tenofovir provoked a slight reduction in eGFR that stabilized after 6 months. The reduced BMD at baseline did not worsen under tenofovir treatment.

Tenofovir monotherapy for hepatitis B after 1 year does not produce renal dysfunction, but is associated with hyperparathyroidism not related to vitamin D

“…Nevertheless, data on the relationship between hepatitis B-infected patients and levels of PTH are scarce, and favor a relationship with hypovitaminosis D rather than TDF alone [49]. Despite this, our study confirms a significant increase in PTH levels; however, we did not find an exact causal relation between the axis serum/urinary-calcium/phosphate, 25(OH)vitamin D, and respective levels of PTH during and at the end of the study.…”

Nucleotide Analogue-Related Proximal Renal Tubular Dysfunction during Long-Term Treatment of Chronic Hepatitis B: A Cross-Sectional Study

“…In this study, acid loading test and the investigation of aminoaciduria were not done to confirm the diagnosis of Fanconi syndrome, although some patients with overt proximal RTD shared many features of Fanconi syndrome. Osteoporosis and osteopenia were found in 10 (66.7%) patients who had proximal RTD, which was very close to the prevalence of the reduction of bone mineral density in patients who were treated with nucleotide analogues in a previous report [31]. Long-term hypophosphatemia with decreased renal phosphate absorption can lead to osteomalacia and impaired bone health [29].…”

809 Reversal of Proximal Renal Tubular Dysfunction After Nucleotide Analogue Withdrawal in Chronic Hepatitis B

“…Prolonged hypophosphatemia with decreased renal phosphate absorption can lead to impaired bone health [37]. In this study, the prevalence of osteoporosis and osteopenia was 62.5%, which was close to the prevalence of nucleotide analogue-related bone demineralization reported from a previous study [38]. The long-term outcome of osteoporosis and osteopenia after nucleotide analogue therapy withdrawal is not known and should be further explored.…”