title: Impact of nucleos(t)ide analogue combination therapy on the estimated glomerular filtration rate in patients with chronic hepatitis B.
abstract: Monotherapy with telbivudine or adefovir can affect estimated the glomerular filtration rate (eGFR). However, only a few studies have assessed changes in eGFR in patients who have chronic hepatitis B (CHB) and are receiving nucleos(t)ide analogue (NA) combination therapy. In our study, we aimed to evaluate the effects of long-term NA combination therapy on eGFR in Chinese CHB patients. This retrospective study included 195 CHB patients. Patient subgroups included those treated with lamivudine plus adefovir (n = 73), telbivudine plus adefovir (n = 51), and entecavir plus adefovir (n = 35); untreated patients (n = 36) served as a control group. After an average follow-up duration of 24 months with combination therapy, analysis of changes in eGFR from baseline values, calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) formulas, showed decrease by 11.08 and 18.34 mL/min (P < .001), respectively, in the lamivudine plus adefovir group; decrease by 3.73 and 10.04 mL/min (P = .012), respectively, in the entecavir plus adefovir group; and increase by 0.91 and 2.12 mL/min (P = .46), respectively, in the telbivudine plus adefovir group. The eGFR in the telbivudine plus adefovir group was similar to that for the untreated group. The eGFR decreases due to adefovir therapy could be rescued by adding telbivudine, and the eGFR increase due to telbivudine could be compromised by adding adefovir. Adefovir in combination with lamivudine or entecavir therapy was significantly associated with decreased eGFR, but telbivudine could rescue the eGFR decrease that results from adefovir treatment.
authors.affiliation: From the Department of Infectious Diseases, Huashan Hospital (XQ, JW, YH, YQ, RM, JZ); Department of Hepatitis Disease, Shanghai Public Health Clinical Center (XQ, LC, YH); and Key laboratory of Medical Molecular Virology of the Ministries of Education and Health (MOH&MOE), Fudan University, Shanghai, China (JZ).
authors.forename: Xun
authors.initials: X
authors.lastname: Qi
authors.forename: Jinyu
authors.initials: J
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Yuxian
authors.initials: Y
authors.lastname: Huang
authors.forename: Yanli
authors.initials: Y
authors.lastname: Qin
authors.forename: Richeng
authors.initials: R
authors.lastname: Mao
authors.forename: Jiming
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009711:Nucleotides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D063065:Organophosphonates / Q000627:therapeutic use; D012189:Retrospective Studies; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D009705:Nucleosides; D009711:Nucleotides; D063065:Organophosphonates; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000225:Adenine; D013936:Thymidine