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Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients
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| Zeitschriftentitel: | Alimentary Pharmacology & Therapeutics |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | Alimentary Pharmacology & Therapeutics, 47, 2018, 12, S. 1673-1681 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Wiley
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| Schlagwörter: |
| author_facet |
Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. |
|---|---|
| author |
Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. |
| spellingShingle |
Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. Alimentary Pharmacology & Therapeutics Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients Pharmacology (medical) Gastroenterology Hepatology |
| author_sort |
tsai, h. j. |
| spelling |
Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. 0269-2813 1365-2036 Wiley Pharmacology (medical) Gastroenterology Hepatology http://dx.doi.org/10.1111/apt.14682 <jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Renal dysfunction remains an issue in tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB) patients.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To evaluate renal safety of TDF according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively recruited CHB patients who received either TDF or entecavir (ETV) monotherapy from January 2008 to August 2015. After excluding confounding conditions, 253 patients who received TDF were randomly matched 1:2 with 506 patients who received ETV through the propensity scores, which consisted of age, gender, cirrhosis, chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR). Renal function deterioration was defined as a drop in GFR category accompanied with a ≥25% eGFR decline. Cumulative incidences of and hazard ratios (HRs) for renal dysfunction were analysed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The mean eGFR decline was significantly greater in the TDF group over 48 months (TDF vs ETV: 15.73 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% confidence interval [CI]: 13.76‐17.70 vs 5.96 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% CI: 4.72‐7.19; <jats:italic>P </jats:italic>< 0.001). The cumulative incidence of renal function deterioration was significantly higher in the TDF group (TDF vs ETV: 11.1%, 95% CI: 7.4‐14.8 vs 1.7%, 95% CI: 1.0‐2.4; <jats:italic>P </jats:italic>< 0.001). After adjusting for age, pre‐existing CKD and diabetes, TDF was independently associated with an increased risk of renal function deterioration (HR 5.36, 95% CI: 2.16‐13.35; <jats:italic>P</jats:italic> < 0.001). Pre‐existing CKD (HR 6.71, 95% CI: 2.25‐17.65), proteinuria (HR 3.39, 95% CI: 1.23‐9.39), and haematuria (HR 4.25, 95% CI: 1.32‐13.68) were also independent factors of renal dysfunction.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>By following the KDIGO guidelines, we confirmed that TDF was associated with a higher risk of renal dysfunction as compared to ETV.</jats:p></jats:sec> Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients Alimentary Pharmacology & Therapeutics |
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10.1111/apt.14682 |
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Medizin Chemie und Pharmazie |
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Wiley, 2018 |
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Wiley, 2018 |
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1365-2036 0269-2813 |
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1365-2036 0269-2813 |
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Alimentary Pharmacology & Therapeutics |
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| title |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_unstemmed |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_full |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_fullStr |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_full_unstemmed |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_short |
Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_sort |
using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis b patients |
| topic |
Pharmacology (medical) Gastroenterology Hepatology |
| url |
http://dx.doi.org/10.1111/apt.14682 |
| publishDate |
2018 |
| physical |
1673-1681 |
| description |
<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Renal dysfunction remains an issue in tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB) patients.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To evaluate renal safety of TDF according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively recruited CHB patients who received either TDF or entecavir (ETV) monotherapy from January 2008 to August 2015. After excluding confounding conditions, 253 patients who received TDF were randomly matched 1:2 with 506 patients who received ETV through the propensity scores, which consisted of age, gender, cirrhosis, chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR). Renal function deterioration was defined as a drop in GFR category accompanied with a ≥25% eGFR decline. Cumulative incidences of and hazard ratios (HRs) for renal dysfunction were analysed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The mean eGFR decline was significantly greater in the TDF group over 48 months (TDF vs ETV: 15.73 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% confidence interval [CI]: 13.76‐17.70 vs 5.96 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% CI: 4.72‐7.19; <jats:italic>P </jats:italic>< 0.001). The cumulative incidence of renal function deterioration was significantly higher in the TDF group (TDF vs ETV: 11.1%, 95% CI: 7.4‐14.8 vs 1.7%, 95% CI: 1.0‐2.4; <jats:italic>P </jats:italic>< 0.001). After adjusting for age, pre‐existing CKD and diabetes, TDF was independently associated with an increased risk of renal function deterioration (HR 5.36, 95% CI: 2.16‐13.35; <jats:italic>P</jats:italic> < 0.001). Pre‐existing CKD (HR 6.71, 95% CI: 2.25‐17.65), proteinuria (HR 3.39, 95% CI: 1.23‐9.39), and haematuria (HR 4.25, 95% CI: 1.32‐13.68) were also independent factors of renal dysfunction.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>By following the KDIGO guidelines, we confirmed that TDF was associated with a higher risk of renal dysfunction as compared to ETV.</jats:p></jats:sec> |
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| author | Tsai, H. J., Chuang, Y. W., Lee, S. W., Wu, C. Y., Yeh, H. Z., Lee, T. Y. |
| author_facet | Tsai, H. J., Chuang, Y. W., Lee, S. W., Wu, C. Y., Yeh, H. Z., Lee, T. Y., Tsai, H. J., Chuang, Y. W., Lee, S. W., Wu, C. Y., Yeh, H. Z., Lee, T. Y. |
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| description | <jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Renal dysfunction remains an issue in tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB) patients.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To evaluate renal safety of TDF according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively recruited CHB patients who received either TDF or entecavir (ETV) monotherapy from January 2008 to August 2015. After excluding confounding conditions, 253 patients who received TDF were randomly matched 1:2 with 506 patients who received ETV through the propensity scores, which consisted of age, gender, cirrhosis, chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR). Renal function deterioration was defined as a drop in GFR category accompanied with a ≥25% eGFR decline. Cumulative incidences of and hazard ratios (HRs) for renal dysfunction were analysed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The mean eGFR decline was significantly greater in the TDF group over 48 months (TDF vs ETV: 15.73 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% confidence interval [CI]: 13.76‐17.70 vs 5.96 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% CI: 4.72‐7.19; <jats:italic>P </jats:italic>< 0.001). The cumulative incidence of renal function deterioration was significantly higher in the TDF group (TDF vs ETV: 11.1%, 95% CI: 7.4‐14.8 vs 1.7%, 95% CI: 1.0‐2.4; <jats:italic>P </jats:italic>< 0.001). After adjusting for age, pre‐existing CKD and diabetes, TDF was independently associated with an increased risk of renal function deterioration (HR 5.36, 95% CI: 2.16‐13.35; <jats:italic>P</jats:italic> < 0.001). Pre‐existing CKD (HR 6.71, 95% CI: 2.25‐17.65), proteinuria (HR 3.39, 95% CI: 1.23‐9.39), and haematuria (HR 4.25, 95% CI: 1.32‐13.68) were also independent factors of renal dysfunction.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>By following the KDIGO guidelines, we confirmed that TDF was associated with a higher risk of renal dysfunction as compared to ETV.</jats:p></jats:sec> |
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| spelling | Tsai, H. J. Chuang, Y. W. Lee, S. W. Wu, C. Y. Yeh, H. Z. Lee, T. Y. 0269-2813 1365-2036 Wiley Pharmacology (medical) Gastroenterology Hepatology http://dx.doi.org/10.1111/apt.14682 <jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Renal dysfunction remains an issue in tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB) patients.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To evaluate renal safety of TDF according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively recruited CHB patients who received either TDF or entecavir (ETV) monotherapy from January 2008 to August 2015. After excluding confounding conditions, 253 patients who received TDF were randomly matched 1:2 with 506 patients who received ETV through the propensity scores, which consisted of age, gender, cirrhosis, chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR). Renal function deterioration was defined as a drop in GFR category accompanied with a ≥25% eGFR decline. Cumulative incidences of and hazard ratios (HRs) for renal dysfunction were analysed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The mean eGFR decline was significantly greater in the TDF group over 48 months (TDF vs ETV: 15.73 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% confidence interval [CI]: 13.76‐17.70 vs 5.96 mL/min/1.73 m<jats:sup>2</jats:sup>, 95% CI: 4.72‐7.19; <jats:italic>P </jats:italic>< 0.001). The cumulative incidence of renal function deterioration was significantly higher in the TDF group (TDF vs ETV: 11.1%, 95% CI: 7.4‐14.8 vs 1.7%, 95% CI: 1.0‐2.4; <jats:italic>P </jats:italic>< 0.001). After adjusting for age, pre‐existing CKD and diabetes, TDF was independently associated with an increased risk of renal function deterioration (HR 5.36, 95% CI: 2.16‐13.35; <jats:italic>P</jats:italic> < 0.001). Pre‐existing CKD (HR 6.71, 95% CI: 2.25‐17.65), proteinuria (HR 3.39, 95% CI: 1.23‐9.39), and haematuria (HR 4.25, 95% CI: 1.32‐13.68) were also independent factors of renal dysfunction.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>By following the KDIGO guidelines, we confirmed that TDF was associated with a higher risk of renal dysfunction as compared to ETV.</jats:p></jats:sec> Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients Alimentary Pharmacology & Therapeutics |
| spellingShingle | Tsai, H. J., Chuang, Y. W., Lee, S. W., Wu, C. Y., Yeh, H. Z., Lee, T. Y., Alimentary Pharmacology & Therapeutics, Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients, Pharmacology (medical), Gastroenterology, Hepatology |
| title | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_full | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_fullStr | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_full_unstemmed | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_short | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| title_sort | using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis b patients |
| title_unstemmed | Using the chronic kidney disease guidelines to evaluate the renal safety of tenofovir disoproxil fumarate in hepatitis B patients |
| topic | Pharmacology (medical), Gastroenterology, Hepatology |
| url | http://dx.doi.org/10.1111/apt.14682 |