Evaluating the renal safety of tenofovir disoproxil fumarate in hepatitis B patients without chronic kidney disease

doi:10.1111/jvh.13603

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23737

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23737

Title:	Evaluating the renal safety of tenofovir disoproxil fumarate in hepatitis B patients without chronic kidney disease
Authors:	Tsai, HJ;Chuang, YW;Yang, SS;Chang, YZ;Chang, HR;Lee, TY
Keywords:	ageing;entecavir;hepatitis B virus;renal dysfunction;tenofovir
Date:	2021
Issue Date:	2022-08-05T09:42:04Z (UTC)
Publisher:	WILEY
ISSN:	1352-0504
Abstract:	The nephrotoxicity of tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB) patients without chronic kidney disease (CKD) remains controversial. We aimed to evaluate nephrotoxicity of TDF in this population. In this hospital-based cohort study, CHB patients who received either TDF or entecavir (ETV) therapy, and did not have underlying CKD, were retrospectively recruited from January, 2008 to January, 2019. After excluding those with confounding conditions, 257 TDF-treated patients were matched through propensity scores with 514 ETV-treated patients. Cumulative incidences of, and hazard ratios (HRs) for the CKD guideline-defined renal dysfunction, were analysed. The mean decline in glomerular filtration rate was similar over 60 months (TDF vs. ETV: 10.1 ml/min/1.73 m(2), 95% confidence interval [CI]: 7.4-12.7 vs. 8.0 ml/min/1.73 m(2), 95% CI: 6.4-9.6; p = .34). The 5-year cumulative incidence of renal dysfunction was not significantly different (TDF vs. ETV: 10.4%, 95% CI: 5.6-18.0 vs. 5.8%, 95% CI: 3.6-9.0; p = .18). However, in multivariable stratified analysis, TDF was associated with an increased risk of renal dysfunction in the elderly (age >= 60 years), when compared to ETV (HR 2.86, 95% CI: 1.02-8.01; p < .05). For confirming the effect of TDF amongst the elderly, 61 TDF-treated patients were further matched with 183 ETV-treated patients, with 5-year cumulative incidence of renal dysfunction being significantly higher in TDF users (TDF vs. ETV: 34.4%, 95% CI: 17.7-59.8 vs. 15.5%, 95% CI: 9.4-25.1; p < .05). TDF use was independently related to renal dysfunction (HR 2.71, 95% CI: 1.19-6.14; p < .05). Although TDF is generally safe for CHB patients without CKD, it is best to be avoided in the elderly.
URI:	http://dx.doi.org/10.1111/jvh.13603 https://www.webofscience.com/wos/woscc/full-record/WOS:000694982700001 https://ir.csmu.edu.tw:8080/handle/310902500/23737
Relation:	JOURNAL OF VIRAL HEPATITIS ,2021,v28,issue 11, P1579-1586
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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