Changes in renal function parameters during nucleos(t)ide analogues (NA) treatment in patients with chronic hepatitis B

C Freissmuth; S Beinhardt; R Stern; K Kozbial; M Eder; AF Stättermayer; M Trauner; P Ferenci; H Hofer

doi:10.1055/s-0035-1551775

Zeitschrift für Gastroenterologie, Inhaltsverzeichnis

Changes in renal function parameters during nucleos(t)ide analogues (NA) treatment in patients with chronic hepatitis B

C Freissmuth ¹, S Beinhardt ¹, R Stern ¹, K Kozbial ¹, M Eder ¹, AF Stättermayer ¹, M Trauner ¹, P Ferenci ¹, H Hofer ¹

¹Medizinische Universität Wien, Klinik f. Innere Medizin III, Abt. f. Gastroenterologie und Hepatologie, Wien, Austria

Abstract

Background & aim:

Telbivudine (LdT), Tenofovir (TDF) and Entecavir (ETV) are nucleos(t)ide analogues (NA) for the treatment of chronic hepatitis B (CHB). Whereas, impairment of renal function is of concern in long-term treatment with TDF, LdT has been reported to be associated with beneficial effects on renal function. Aim of this study was to evaluate renal function parameters in patients with CHB during treatment with NA.

Patients & methods:

A total of 133 CHB patients (m/f = 99/34, mean age: 40.7 ± 12.2 years (mean ± SD), HBV-genotype D: 57%) treated with ETV (n = 30), LdT (n = 39) and TDF (n = 64) were retrospectively evaluated. Serum creatinine (Cr; mg/dl) was analyzed at baseline, after 6 months, 12 months and once a year during antiviral therapy. Estimated glomerular filtration rate (eGFR; mL/min) was calculated according to Cockroft-Gault. Patients on renal replacement therapy were excluded.

Results:

Serum creatinin levels and eGFR were comparable at baseline among LdT, TDF and ETV treated patients (eGFR_LdT110.624.3 ml/min, eGFR_TDF109.932.5, eGFR_ETV117.933.0; n.s. respectively). Serum creatinin increased and eGFR decreased in patients treated with TDF from baseline to 6 months (Cr_TDF-BL: 0.890.15, Cr_TDF-6Mo: 0.940.19; eGFR_TDF-BL: 109.932.5, eGFR_TdF-6Mo: 105.833.5, p < 0.05) with no further changes at 12 months (Cr_TDF-12Mo: 0.930.18; eGFR_TDF-12Mo: 108.532.7) or later on during treatment. Serum creatinin and eGFR did not change in patients with LdT or ETV therapy from baseline to 6 and 12 months of NA treatment.

Conclusion:

TDF therapy shows a small but significant effect on serum creatinin levels and eGFR during the first 6 months of antiviral treatment with no further deterioration afterwards. ETV and LdT treatment did not show any effect on serum creatinin and eGFR in our cohort. Further study to investigate the long-term effects of different NA on renal function are needed.