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Effects of Entecavir and Tenofovir on Renal Function in Patients with Hepatitis B Virus-Related Compensated and Decompensated Cirrhosis

Authors
 Jihye Park  ;  Kyu Sik Jung  ;  Hye Won Lee  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Jun Yong Park 
Citation
 Gut and Liver, Vol.11(6) : 828-834, 2017 
Journal Title
 Gut and Liver 
ISSN
 1976-2283 
Issue Date
2017
Keywords
Entecavir ; Fibrosis ; Hepatitis B ; Renal safety ; Tenofovir
Abstract
Background/Aims: The renal effects of nucleos(t)ide analogs in patients with chronic hepatitis B are controversial. We aimed to compare the impact of entecavir (ETV) and tenofovir (TDF) on renal function in patients with hepatitis B virus (HBV)-related cirrhosis. Methods: We performed a retrospective cohort study of 235 consecutive treatment-naïve patients with HBV-related cirrhosis who were treated with ETV or TDF between December 2012 and November 2013 at Severance Hospital, Seoul, Korea. Results: Compensated cirrhosis was noted in 183 patients (ETV 130, TDF 53), and decompensated cirrhosis was noted in 52 patients (ETV 32, TDF 20). There were no significant changes in estimated glomerular filtration rates (eGFR) from baseline in either the ETV- or TDF-treated groups at week 96 (Chronic Kidney Disease Epidemiology Collaboration, ETV -1.68% and TDF -5.03%, p=0.358). Using a multivariate analysis, the significant factors associated with a decrease in eGFR >20% were baseline eGFR, diabetes mellitus (DM), and the use of diuretics. The use of antiviral agents and baseline decompensation were not determined to be significant factors. Conclusions: In patients with HBV-related cirrhosis, TDF has shown similar renal safety to that of ETV over a 2-year period. Renal function should be closely monitored, especially in patients who exhibit decreasing eGFR, DM, and the use of diuretics.
DOI
10.5009/gnl16484
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김도영(Kim, Do Young)
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
박지혜(Park, Ji Hye)
안상훈(Ahn, Sang Hoon)
이혜원(Lee, Hye Won) ORCID logo https://orcid.org/0000-0002-3552-3560
정규식(Jung, Kyu Sik)
한광협(Han, Kwang Hyup)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161357
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