Renal impairment in patients with chronic hepatitis C treated with first generation protease inhibitors

Kozielewicz, Dorota; Dybowska, Dorota; Karwowska, Kornelia; Wietlicka-Piszcz, Magdalena

doi:10.1517/14740338.2015.1102882

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Nevertheless, in a large cohort (1486 patients), Mauss et al[10] showed a reversible decrease of eGFR in patients taking telaprevir or boceprevir. Similar reports involving telaprevir therapy confirmed this observation and suggested a link with anemia occurrence[75-78]. Recently, Kunze et al[30] described competition between telaprevir and OCT2, which interacts with creatinine tubular transport and is involved in proximal tubular secretion.…”

Section: Specific Nephrotoxicity Of Hcv Drugssupporting

confidence: 57%

Anti-hepatitis C virus drugs and kidney

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Essig

Debette-Gratien

et al. 2016

WJH

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Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin. The first results were convincing. To aid in the correct use of these drugs in patients with renal insufficiency, their pharmacokinetic properties and potential renal toxicity must be known. The renal toxicity of these new drugs was not a safety signal in clinical trials, and the drugs are generally efficient in these frail populations. These drugs are usually well tolerated, but recent cohort studies have demonstrated that these new regimens may be associated with renal side effects, especially when using sofosbuvir combinations. HCV, renal diseases and comorbidities are intimately linked. The close monitoring of renal function is required, particularly for at-risk patients (transplanted, HIV-coinfected, CKD, hypertensive or diabetic patients). New DAA regimens, which will soon be approved, will probably change the landscape.

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