Influence of long-term use of entecavir on renal tubular function in patients with chronic hepatitis B
10.3969/j.issn.1001-5256.2023.06.010
- VernacularTitle:长期使用恩替卡韦对慢性乙型肝炎患者肾小管功能的影响
- Author:
Yuanmei CHE
1
,
2
;
Ai LI
1
,
3
;
Liang WANG
1
;
Lunli ZHANG
1
;
Xiaopeng LI
1
Author Information
1. Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
2. Department of Infectious Diseases, Jiangxi Provincial People's Hospital, Nanchang 330006, China
3. Department of Blood Transfusion, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, China
- Publication Type:Original Article_Viral Hepatitis
- Keywords:
Hepatitis B, Chronic;
Entecavir;
Acute Kidney Injury
- From:
Journal of Clinical Hepatology
2023;39(6):1313-1317
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the possible influence of long-term antiviral therapy with entecavir on renal function in patients with chronic hepatitis B (CHB) and the sensitive indicators for early identification of renal injury. Methods A cross-sectional real-world study was conducted for the clinical data of 125 CHB patients treated with entecavir for more than 1 year (treatment group) and 44 patients with chronic HBV infection who did not receive antiviral therapy (control group), including the changes in serum creatinine (SCr), estimated glomerular filtration rate (eGFR), and the levels of urinary α1 microglobulin (α1-MG), β2 microglobulin (β2-MG), and N-acetyl-β-D-glucosaminidase (NAG). The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The Logistic regression analysis was used to investigate independent influencing factors for abnormal urinary α1-MG, β2-MG, and NAG in the treatment group. Results There were no significant differences in SCr and eGFR between the treatment group and the control group ( t =0.999 and -1.259, P > 0.05), and both indices were within the normal range in these two groups. The treatment group had significantly higher abnormal rates of urinary α1-MG and β2-MG than the control group (47.2%/42.4% vs 13.6%/13.6%, χ 2 =15.693 and 12.567, both P < 0.001), and compared with the control group, the treatment group had a significantly higher proportion of patients with α1-MG or β2-MG > 2×upper limit of normal (18.4%/21.6% vs 2.3%/4.5%, both P < 0.05); however, there were no significant differences between the treatment group and the control group in the abnormal rate of urinary NAG (8.0% vs 6.8%, P > 0.05) and the proportion of patients with urinary NAG > 2×upper limit of normal (8.8% vs 6.8%, P > 0.05). Compared with the control group, the treatment group had a significantly higher proportion of patients with abnormalities in two or more indicators for renal tubular injury (33.6% vs 11.4%, χ 2 =8.519, P < 0.05), while there was no significant difference between the two groups in the proportion of patients with abnormalities in one indicator (16.0% vs 11.4%, P > 0.05). Conclusion Long-term treatment of CHB with entecavir may be associated with the risk of renal tubular dysfunction, and abnormalities in more than two indicators for renal injury may help to identify renal tubular dysfunction in patients, so as to adjust related treatment in time.
