title: Renal impairment in patients with chronic hepatitis C treated with first generation protease inhibitors.
abstract: BACKGROUND
  The incidence, course and risk factors associated with renal impairment (RI) in patients treated with triple therapy (TT) with pegylated interferon, ribavirin and telaprevir/boceprevir (PR/TVR/BOC) vs. dual therapy (DT) with PR were analyzed in this study. The association between RI and the decline of hemoglobin (Hb) was also examined.
  
  
  METHODS
  Retrospective analysis included 110 patients with genotype 1b chronic HCV infection, aged 18 - 80 years, who underwent TT (48TVR/14BOC) or DT (48 patients). The estimated glomerular filtration rate (eGFR), serum creatinine concentration (SCr) and Hb were measured at baseline, at weeks 4, 12, 24, 48 of treatment, and post-treatment week 24.
  
  
  RESULTS
  RI occurred in 9/62 (14.5%) patients who underwent TT, eight of whom were treated with TVR, one with BOC, and none treated with DT. The risk factors associated with RI were the following: TT (p = 0.0078), usage of nephrotoxic drugs (p = 0.0288), and older age (p < 0.0001). RI was reversible. A drop of Hb was associated with RI, older age and TT.
  
  
  CONCLUSIONS
  RI is not a rare but a reversible complication of TT. It is necessary to monitor SCr and eGFR, especially in patients with a potential risk factor of RI occurrence. The Hb drop is more severe in patients with RI than in those without it.
authors.affiliation: a Department of Infectious Diseases and Hepatology, Faculty of Medicine , Nicolaus Copernicus University in Toruń , Bydgoszcz , Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Kozielewicz
authors.affiliation: a Department of Infectious Diseases and Hepatology, Faculty of Medicine , Nicolaus Copernicus University in Toruń , Bydgoszcz , Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Dybowska
authors.affiliation: a Department of Infectious Diseases and Hepatology, Faculty of Medicine , Nicolaus Copernicus University in Toruń , Bydgoszcz , Poland.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Karwowska
authors.affiliation: b Department of Theoretical Foundations of Biomedical Sciences and Medical Computer Science , Faculty of Pharmacy, Nicolaus Copernicus University in Toruń , Bydgoszcz , Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wietlicka-Piszcz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011392:Proline / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000453:epidemiology; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006454:Hemoglobins; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a
keywords: boceprevir; chronic hepatitis C; renal impairment; telaprevir