Value of Cystatin C–Based e-GFR Measurements to Predict Long-Term Tenofovir Nephrotoxicity in Patients With Hepatitis B

Köksal, Ali; Alkım, Hüseyin; Boğa, Salih; İyisoy, Mehmet Sinan; Şen, İ̇lker; Neijmann, Şebnem Tekin; Alkım, Canan

doi:10.1097/mjt.0000000000000518

Cited by 9 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The eGFRs of patients treated with TDF decreased in a time-dependent manner, whereas those of patients treated with ETV increased or decreased across various time points. 15 , 16 , 20 , 23 , 24 , 28 Similar percentage of patients in both the treatment groups showed ≥20% decrease in eGFR during the treatment (based on CG, TDF 35.0% vs ETV 36.3%; based on MDRD, TDF 41.3% vs ETV 43.8%). 33 A similar tendency was also observed in a recent clinical trial conducted in Thailand.…”

Section: Discussionmentioning

confidence: 86%

“…A prospective cohort study conducted in Turkey reported a change in eGFR in 44 patients with TDF and 32 patients with ETV according to the Chronic Kidney Disease Epidemiology Collaboration and cystatin C (CKD-EPI-CysC) method. 16 The mean eGFR in the patients with TDF decreased from 84.7 mL/min/1.73 m 2 at BL to 76.9 mL/min/1.73 m 2 at 24 months ( p =0.004) and that in the patients with ETV decreased from 90.0 mL/min/1.73 m 2 at BL to 84.5 mL/min/1.73 m 2 at 24 months ( p =0.46). However, the mean values of eGFR in both groups were different when the Chronic Kidney Disease Epidemiology Collaboration and creatinine plus cystatin C (CKD-EPI-Cr-CysC) method was used.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Renal safety of tenofovir and/or entecavir in patients with chronic HBV monoinfection

Yang¹,

Choi²

2017

TCRM

View full text Add to dashboard Cite

BackgroundTenofovir disoproxil fumarate (TDF) and entecavir (ETV) are recommended as the first-line therapy for chronic hepatitis B (CHB) due to their genetic barrier to resistance and effectiveness of virological suppression. TDF and ETV may cause renal toxicity through various mechanisms such as renal tubular injury, apoptosis, and mitochondrial toxicity. The aims of the current review were to assess the potential renal toxicity associated with the use of TDF and ETV in patients infected with chronic hepatitis B virus (HBV) and to provide clinical perspectives on these two agents in the treatment of CHB.MethodsA literature search of clinical studies published in PubMed and posted on ClinicalTrials.gov website was implemented to find studies evaluating the potential renal toxicity of TDF and ETV.ResultsTwenty-one studies were examined in this review. The TDF dose used in the studies was 245 or 300 mg/day and that of ETV was 0.5 or 1 mg/day. Based on the markers of renal function, patients treated with TDF were not more likely to show changes in renal function than those treated with ETV; however, the estimated glomerular filtration rates (eGFRs) of patients receiving TDF tended to be more clearly reduced than those of patients receiving ETV. The eGFRs of patients treated with TDF decreased in a time-dependent manner, whereas those of patients treated with ETV increased or decreased across various time points.ConclusionThe data shown in this study suggest that use of TDF and ETV could be at least associated with reductions in renal function in patients with chronic HBV infection. However, various risk factors, such as pre-existing renal failure and comorbidities, are also associated with decreased renal function during the treatment of TDF and ETV. Thus, studies of management strategies for HBV-infected patients with these risk factors are necessary in the near future.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Renal safety of tenofovir and/or entecavir in patients with chronic HBV monoinfection

Yang¹,

Choi²

2017

TCRM

View full text Add to dashboard Cite

show abstract

“…For instance, CHB patients with cirrhosis are more likely to develop renal insu ciency, including acute kidney injury or hepatorenal syndrome, due to reduced renal blood ow and hemodynamic disturbances [10]. Furthermore, renal tubular dysfunction and Fanconi syndrome have been associated with TDF therapy for a decade [11][12][13]. Subsequently, several studies have reported the comparative analyses of renal function between patients receiving ETV and TDF; however, these studies had small sample sizes [14,15] and short follow-up periods [16,17].…”

Section: Introductionmentioning

confidence: 99%

Long‐term renal safety between patients with chronic hepatitis B receiving tenofovir vs. entecavir therapy: A multicenter study

Chon

Park

Hong

et al. 2022

Journal of Viral Hepatitis

View full text Add to dashboard Cite

BackgroundRenal safety is a critical issue in chronic hepatitis B (CHB) patients receiving long-term entecavir (ETV) or tenofovir disofuroxil fumarate (TDF) therapy. We investigated their effects on estimated glomerular ltration rate (eGFR). MethodsTreatment-naïve CHB patients receiving ETV or TDF for ≥1 year were recruited. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation. We calculated average annual percent change (AAPC) in eGFR using Joinpoint regression. ResultsAt beginning of observation, ETV group had unfavorable conditions than TDF group: lower eGFR and higher FIB-4 and APRI than TDF group (all P<0.001). After 6 years antiviral therapy, the mean eGFR in ETV group (n=1,793) was maintained (96.0 at rst year to 95.6 mL/min/1.73 m 2 at sixth year; AAPC -0.09%; P=0.322), whereas that in TDF group (n=1,240) signi cantly decreased annually (101.9 at rst year to 96.9 mL/min/1.73 m 2 at sixth year; AAPC -0.88%; P<0.001). Notably, in TDF group, even patients without diabetes (AAPC -0.80%; P=0.001) or hypertension (AAPC -0.87%; P=0.001) experienced signi cant decrease in eGFR. Expectably, accompanying diabetes (AAPC -1.59%; p=0.011) or hypertension (AAPC -1.00%; p=0.002) tended to accelerate eGFR decrease. TDF treatment (odds ratio 1.66, P<0.001), along with eGFR<60 mL/min/1.73 m 2 , serum albumin<3.5 mg/dL, and hypertension, were independently associated with ongoing renal dysfunction, de ned as a negative slope of the mean eGFR change. ConclusionsCompared to ETV, long-term TDF treatment induced slow, but progressive renal dysfunction. Although the annual eGFR change by TDF was small, careful monitoring is necessary, especially in patients requiring life-long therapy.

show abstract

“…Cys C serum levels also increased in cigarette smoking, cancer, neurological, and atherosclerosis. [27]…”

Section: Biomarkers Of Nephrotoxicitymentioning

confidence: 99%

Nephrotoxicity: Role and significance of renal biomarkers in the early detection of acute renal injury

Al-Naimi

Rasheed

Hussien

et al. 2019

J Adv Pharm Technol Res

View full text Add to dashboard Cite

Nephrotoxicity is defining as rapid deterioration in the kidney function due to toxic effect of medications and chemicals. There are various forms, and some drugs may affect renal function in more than one way. Nephrotoxins are substances displaying nephrotoxicity. Different mechanisms lead to nephrotoxicity, including renal tubular toxicity, inflammation, glomerular damage, crystal nephropathy, and thrombotic microangiopathy. The traditional markers of nephrotoxicity and renal dysfunction are blood urea and serum creatinine which are regarded as low sensitive in the detection of early renal damage. Thus, the detection of the initial renal injures required new biomarkers which are more sensitive and highly specific that gives an insight into the site of underlying renal damage. Kidney injury molecule-1, Cystatin C, and neutrophil gelatinase-associated lipocalin sera levels are more sensitive than blood urea and serum creatinine in the detection of acute kidney injury during nephrotoxicity.

show abstract

Value of Cystatin C–Based e-GFR Measurements to Predict Long-Term Tenofovir Nephrotoxicity in Patients With Hepatitis B

Abstract: Long-term tenofovir disoproxil fumarate nephrotoxicity can be predicted by serum cystatin C plus creatinine-based e-GFR measured before treatment.

Cited by 9 publications

References 15 publications

Renal safety of tenofovir and/or entecavir in patients with chronic HBV monoinfection

Renal safety of tenofovir and/or entecavir in patients with chronic HBV monoinfection

Long‐term renal safety between patients with chronic hepatitis B receiving tenofovir vs. entecavir therapy: A multicenter study

Nephrotoxicity: Role and significance of renal biomarkers in the early detection of acute renal injury

Contact Info

Product

Resources

About