TY - JOUR
T1 - Altered underlying renal tubular function in patients with chronic hepatitis B receiving nucleos(t)ide analogs in a real-world setting the MENTE study
AU - Rodriguez-Novoa, Sonia
AU - Garcia-Samaniego, Javier
AU - Prieto, Martin
AU - Calleja, Jose L.
AU - Pascasio, Juan M.
AU - Blanco, Manuel Delgado
AU - Crespo, Javier
AU - Buti, Maria
AU - Bonet Vidal, Maria L.
AU - Arenas Ruiz Tapiador, Juan
AU - Fernandez-Rodriguez, Conrado
AU - Solà, Ricard
AU - Fraga, Enrique
AU - Dieguez, Luisa Gonzalez
AU - Nuñez, Oscar
AU - Praga, Manuel
AU - Del Pino-Montes, Javier
AU - Romero-Gomez, Manuel
AU - Morillas, Rosa
AU - Diago, Moises
AU - Castro, Angeles
PY - 2016/1/1
Y1 - 2016/1/1
N2 - © 2016 Wolters Kluwer Health, Inc. All rights reserved. Background: Cases of renal tubular dysfunction have been reported in patients with hepatitis B and in patients with human immunodeficiency virus who are undergoing tenofovir treatment. However, little is known about the impact on tubular function in patients with chronic hepatitis B (CHB) under long-term use of entecavir (ETV) and tenofovir disoproxil fumarate (TDF). We evaluated markers of renal tubular function and bone turnover in patients with CHB treated with ETV or TDF. Patients and Methods: A multicenter, cross-sectional study was performed on markers of renal tubular function and bone turnover in hepatitis B virus-monoinfected patients on long-term treatment with Entecavir or Tenofovir (the MENTE study). The analyzed parameters were: retinol-binding protein/creatinine, neutrophil gelatinase-associated lipocalin/creatinine, excretion of phosphates, uric acid excretion, glomerular filtrate, protein/creatinine, albumin/creatinine, serum creatinine, phosphate, CTX, P1NP, vitamin D, and parathormone. Results: A total of 280 patients (ETV: 89, TDF: 69, control: 122) were included in this study. The TDF group was associated with altered levels of retinol-binding protein (RBP)/creatinine (TDF 25% vs. 7% ETV and control; P < 0.001). Protein/creatinine, uric acid excretion, P1NP1, and parathormone were higher in the TDF group. The proportion of patients with serum phosphate <2.5 mg/dL was higher in both the ETV and the TDF groups compared with the control. The multivariate analysis showed that the use of TDF was independently associated with a higher risk of altered excretion of RBP/creatinine (4.4; interquartile range: 1.4 to 14; P = 0.013). Conclusions: We found an independent association between TDF use and altered RBP excretion. This finding indicates subclinical tubular damage. Because tubular dysfunction can precede the decline of renal function, close monitoring of RBP levels in patients with CHB on nucleos(t)ide analog treatment must be performed for early detection of TDF-related renal toxicity. In this study, these differences in tubular function were not associated with concomitant changes in markers of bone turnover.
AB - © 2016 Wolters Kluwer Health, Inc. All rights reserved. Background: Cases of renal tubular dysfunction have been reported in patients with hepatitis B and in patients with human immunodeficiency virus who are undergoing tenofovir treatment. However, little is known about the impact on tubular function in patients with chronic hepatitis B (CHB) under long-term use of entecavir (ETV) and tenofovir disoproxil fumarate (TDF). We evaluated markers of renal tubular function and bone turnover in patients with CHB treated with ETV or TDF. Patients and Methods: A multicenter, cross-sectional study was performed on markers of renal tubular function and bone turnover in hepatitis B virus-monoinfected patients on long-term treatment with Entecavir or Tenofovir (the MENTE study). The analyzed parameters were: retinol-binding protein/creatinine, neutrophil gelatinase-associated lipocalin/creatinine, excretion of phosphates, uric acid excretion, glomerular filtrate, protein/creatinine, albumin/creatinine, serum creatinine, phosphate, CTX, P1NP, vitamin D, and parathormone. Results: A total of 280 patients (ETV: 89, TDF: 69, control: 122) were included in this study. The TDF group was associated with altered levels of retinol-binding protein (RBP)/creatinine (TDF 25% vs. 7% ETV and control; P < 0.001). Protein/creatinine, uric acid excretion, P1NP1, and parathormone were higher in the TDF group. The proportion of patients with serum phosphate <2.5 mg/dL was higher in both the ETV and the TDF groups compared with the control. The multivariate analysis showed that the use of TDF was independently associated with a higher risk of altered excretion of RBP/creatinine (4.4; interquartile range: 1.4 to 14; P = 0.013). Conclusions: We found an independent association between TDF use and altered RBP excretion. This finding indicates subclinical tubular damage. Because tubular dysfunction can precede the decline of renal function, close monitoring of RBP levels in patients with CHB on nucleos(t)ide analog treatment must be performed for early detection of TDF-related renal toxicity. In this study, these differences in tubular function were not associated with concomitant changes in markers of bone turnover.
KW - Entecavir
KW - Hepatitis B virus
KW - Retinol-binding protein
KW - Tenofovir
KW - Tubular renal toxicity
U2 - 10.1097/MCG.0000000000000569
DO - 10.1097/MCG.0000000000000569
M3 - Article
SN - 0192-0790
VL - 50
SP - 779
EP - 789
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
IS - 9
ER -
