title: Does elevation of serum creatinine in patients with chronic hepatitis C under therapy of telaprevir mean renal impairment?
abstract: OBJECTIVE
  Treatment with telaprevir (TVR) entails adverse side-effects including anaemia and elevation of serum creatinine (SCr) level. Our purpose was to evaluate the effects of treatment with TVR on renal function in adults with chronic hepatitis C.
  
  
  METHODS
  Thirteen adult patients with HCV genotype 1b who were scheduled to be treated with TVR, pegylated interferon (PEG IFN), and ribavirin (RBV) were prospectively followed. Patients were divided into two groups: (i) patients with an increase in SCr during the treatment (n = 8), and (ii) patients without an increase in SCr (n = 5). Urine and serum parameters were evaluated.
  
  
  RESULTS
  Although there was no difference in SCr level between the two groups before HCV therapy, the SCr level was persistently high in the patients in the increase-in-SCr group during the triple therapy. The SCr level returned to the pre-treatment level after cessation of TVR. There were no differences in urinary L-FABP, NAG, serum cystatin C level and eGFRcys throughout the study between the two groups. The serum cystatin C level at pre-treatment tended to be higher in the increase-in-SCr group. Urinary L-FABP and NAG levels in these groups remained within normal limits during treatment. We found that the increase in SCr was not associated with the degree of renal impairment. The increase in SCr may have been induced as a result of a decrease in creatinine secretion from proximal tubules via inhibition of transporters of creatinine induced by TVR.
  
  
  CONCLUSIONS
  Elevation of SCr levels with TVR therapy may not suggest renal impairment.
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Matsui
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.|Department of Anatomy, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kamijo-Ikemori
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugaya
authors.affiliation: Department of Gastroenterology and Hepatology, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Department of Gastroenterology and Hepatology, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Okuse
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Miyamae-Ku, Kanagawa, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007564:Japan; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D016898:Interferon-alpha; D009842:Oligopeptides; D012254:Ribavirin; C486464:telaprevir; D003404:Creatinine
keywords: acute kidney injury; chronic hepatitis C virus infection; liver-type fatty acid-binding protein; multidrug and toxin extrusion transporters; telaprevir