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Comparison of decline in renal function between patients with chronic hepatitis B with or without antiviral therapy

Authors
 Jae Seung Lee  ;  Chan-Young Jung  ;  Jung Il Lee  ;  Sang Hoon Ahn  ;  Beom Seok Kim  ;  Seung Up Kim 
Citation
 ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol.58(1) : 99-109, 2023-07 
Journal Title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN
 0269-2813 
Issue Date
2023-07
MeSH
Antiviral Agents* / therapeutic use ; Hepatitis B, Chronic* / drug therapy ; Humans ; Kidney / physiology ; Retrospective Studies ; Tenofovir / therapeutic use ; Treatment Outcome
Abstract
Background and aims: Renal function can deteriorate in patients with chronic hepatitis B (CHB). We compared the risk of renal function decline between patients with untreated and treated CHB receiving antiviral therapy.

Methods: This retrospective study included 1061 untreated CHB patients, and 366 on tenofovir alafenamide (TAF), 190 on besifovir dipivoxil maleate (BSV), and 2029 on entecavir (ETV). The primary outcome was renal function decline, a ≥ one-stage increase in chronic kidney disease for ≥3 consecutive months.

Results: The incidence and risk of renal function decline were significantly higher in the 1:1 propensity score-matched treated group (588 pairs) than in the untreated (2.7 per 1000 person-years [PYs] vs. 1.3 per 1000 PYs, adjusted hazard ratio [aHR] = 2.29, all p < 0.001). The matched TAF group (222 pairs) showed a similar risk for the primary outcome (aHR = 1.89, p = 0.107) despite a significantly higher incidence thereof, compared to the untreated (3.9 vs. 1.9 per 1000 PYs, p = 0.042). The matched BSV and untreated groups (107 pairs) showed no significant differences in the incidence and risk. However, ETV users (541 pairs) carried a significantly higher outcome incidence and risk than the matched untreated (3.6 vs. 1.1 per 1000 PYs, aHR = 1.05, all p < 0.001). Compared to each matched untreated group, changes in the estimated glomerular filtration rate over time were greater in the ETV group (p = 0.010), despite being similar in the TAF (p = 0.073) and BSV groups (p = 0.926).

Conclusions: Compared with untreated patients, TAF or BSV users showed similar risk, whereas ETV users showed a higher risk of renal function decline.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/apt.17532
DOI
10.1111/apt.17532
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
Lee, Jung Il(이정일) ORCID logo https://orcid.org/0000-0002-0142-1398
Jung, Chan-Young(정찬영) ORCID logo https://orcid.org/0000-0002-2893-9576
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195990
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