Hypophosphatemia predicts a failure to recover from adefovir-related renal injury after dose reduction in lamivudine-resistant hepatitis B patients

Autor:	Naro Ohashi, Yasuhiko Maruyama, Hideo Yasuda, Tatsuo Yamamoto, Masami Shinozaki
Rok vydání:	2017
Předmět:	medicine.medical_specialty Urinary system 030232 urology & nephrology Renal function Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Adefovir Cumulative incidence Hepatology business.industry virus diseases Lamivudine Hepatitis B medicine.disease digestive system diseases Infectious Diseases Endocrinology chemistry Uric acid 030211 gastroenterology & hepatology business Hypophosphatemia medicine.drug
Zdroj:	Hepatology Research. 47:1272-1281
ISSN:	1386-6346
Popis:	Aim In chronic hepatitis B patients receiving 10 mg adefovir, dose reduction is recommended when renal injury appears. However, recovery is not always achieved and markers that recommend switching to another antiviral agent are unknown. We investigated adefovir-related renal injury, recovery after dose reduction, and their predictors. Methods The renal injury in 77 chronic hepatitis B patients receiving 10 mg adefovir and recovery after dose reduction to alternate day administration in those with adefovir-related renal injury were assessed. The predictors for >20% estimated glomerular filtration rate (eGFR) decline following 10 mg adefovir administration and for >20% eGFR recovery after dose reduction were investigated. Results The adefovir dose was reduced in 26 patients (34%) at 59 ± 30 (mean ± SD) months of 10 mg adefovir administration because of decreases in eGFR (cumulative incidence 27%), serum phosphorus (9%) and uric acid (16%) levels, and increases in alkaline phosphatase (20%), bone type alkaline phosphatase (18%), urinary α1-microglobulin (18%) and urinary N-acetyl-β-D-glucosaminidase (18%) levels. ≥50 years of age at the start of 10 mg adefovir administration was the only significant predictor for >20% eGFR decline. The cumulative eGFR recovery rate was 42% at 42 ± 27 months after dose reduction, and ≥2.5 mg/dL of serum phosphorus level at dose reduction was the only significant predictor for >20% eGFR recovery after dose reduction. Conclusion The patients ≥50 years of age are predisposed to adefovir-related renal injury and switching to another antiviral agent rather than adefovir dose reduction is recommended when hypophosphatemia is observed.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::f1d7451910d952c07405da608fb27226 https://doi.org/10.1111/hepr.12865 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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