title: Potential effects of telbivudine and entecavir on renal function: a systematic review and meta-analysis.
abstract: BACKGROUND
  To assess the potential effects of telbivudine (LdT) and entecavir (ETV) on renal function in patients with chronic hepatitis B (CHB), we performed a meta-analysis of the relevant data available on these agents to evaluate their effects on the estimated glomerular filtration rate (eGFR) during treatment.
  
  
  METHODS
  The PubMed, EMBASE, Scopus, CNKI (China National Knowledge Infrastructure), Cochrane Library, and WanFang databases were searched for relevant articles appearing in the literature up to July 1, 2015. A total of 6 studies (1960 CHB patients) with 1-year eGFR outcomes were retrieved and analyzed.
  
  
  RESULTS
  Generally, the results of the 6 studies analyzed showed that eGFR was improved after LdT treatment, but was decreased after ETV treatment. Using a fixed-effects approach, the change in eGFR was found to be significantly different between LdT and ETV treatment (Z = 3.64; P = 0.0003). Whereas the eGFR was slightly decreased with ETV compared with baseline (-1.45 mL/min/1.73 m(2)), the eGFR was improved with LdT (2.99 mL/min/1.73 m(2)) after 1 year of treatment. An overall test of effect in the meta-analysis showed that the eGFR in LdT-treated patients was significantly improved after 1-year of treatment (Z = 3.71; P = 0.0002).
  
  
  CONCLUSIONS
  This meta-analysis has confirmed that LdT has a renal protective effect whereas ETV does not. However, whether the benefit on renal function outweighs the occurrence of resistance in specific clinical situations is not yet clear.
authors.affiliation: First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Wu
authors.affiliation: First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.|Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Shaohang
authors.initials: S
authors.lastname: Cai
authors.affiliation: Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Zhandong
authors.initials: Z
authors.lastname: Li
authors.affiliation: First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Zheng
authors.affiliation: First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
authors.forename: Xiulan
authors.initials: X
authors.lastname: Xue
authors.affiliation: First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
authors.forename: Jianyong
authors.initials: J
authors.lastname: Zeng
authors.affiliation: Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China. pjie138@163.com.|State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Guangzhou, 510515, China. pjie138@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Peng
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002681:China; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000502:physiology*; D007674:Kidney Diseases / Q000139:chemically induced*; D007677:Kidney Function Tests; D000077712:Telbivudine; D013936:Thymidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077712:Telbivudine; C413685:entecavir; D006147:Guanine; D013936:Thymidine
keywords: Chronic hepatitis B; Entecavir; Glomerular filtration rate; Nucleoside analogs; Renal function; Telbivudine