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Adefovir- or Lamivudine-Induced Renal Tubular Dysfunction after Liver Transplantation

Authors
 Jae Geun Lee  ;  Juhan Lee  ;  Jung Jun Lee  ;  Seung Hwan Song  ;  Man Ki Ju  ;  Gi Hong Choi  ;  Myoung Soo Kim  ;  Jin Sub Choi  ;  Soon Il Kim  ;  Dong Jin Joo 
Citation
 MEDICINE, Vol.94(38) : 1569, 2015 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2015
MeSH
Adenine/adverse effects ; Adenine/analogs & derivatives ; Female ; Hepatitis B/epidemiology ; Hepatitis B/prevention & control* ; Humans ; Incidence ; Kidney Diseases/blood ; Kidney Diseases/chemically induced* ; Kidney Diseases/mortality ; Lamivudine/adverse effects ; Liver Transplantation* ; Male ; Middle Aged ; Organophosphonates/adverse effects ; Postoperative Complications/blood ; Postoperative Complications/chemically induced* ; Postoperative Complications/mortality ; Recurrence ; Republic of Korea/epidemiology ; Retrospective Studies ; Reverse Transcriptase Inhibitors/adverse effects* ; Risk Factors
Abstract
To reduce hepatitis B virus reinfection after liver transplantation (LT), patients often receive antihepatitis B immunoglobulin (HBIG) alone or combined with antiviral nucleoside/nucleotide analogs (NUCs); however, proximal renal tubular dysfunction (RTD) that was induced by NUCs in liver recipients was rarely reported. Here, we analyzed RTD and renal impairment (RI) following adefovir (ADV) and lamivudine (LAM) treatment in liver recipients. We retrospectively reviewed medical records of patients treated with HBIG alone (group 1, n = 42) or combined with ADV or LAM (group 2, n = 21) after LT. We compared RTD and RI incidence during the 12 months after LT. An RTD diagnosis required manifestation of at least 3 of the following features: hypophosphatemia, RI, hypouricemia, proteinuria, or glucosuria. No significant differences were observed regarding sex, age, donor type, model of end-stage liver score, and estimated glomerular filtration rate at pre-LT between the 2 groups. Hepatitis B virus recurrence within 12 months was 4.8% in both groups (P = 1.000); however, the RTD incidence was 0% in group 1 and 19.0% in group 2 (P = 0.010). RI occurrence did not differ between the groups. The only risk factor for RI was HBIG administration combined with both LAM and ADV (odds ratio 11.27, 95% confidence interval 1.13-112.07, P = 0.039, vs HBIG alone). RTD occurred more frequently in patients treated with HBIG combined with LAM or ADV compared with HBIG alone. Thus, LAM or ADV therapy can induce RTD after LT, and when administered, liver recipients should be monitored.
Files in This Item:
T201503626.pdf Download
DOI
10.1097/MD.0000000000001569
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Song, Seung Hwan(송승환)
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Lee, Ju Han(이주한)
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Joo, Man Ki(주만기) ORCID logo https://orcid.org/0000-0002-4112-7003
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141205
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