title: Circulating kidney injury molecule-1 is a novel diagnostic biomarker for renal dysfunction during long-term adefovir therapy in chronic hepatitis B.
abstract: The aim of this study was to evaluate serum kidney injury molecule-1 (KIM-1) as a new diagnostic marker of renal dysfunction in chronic hepatitis B (CHB) patients receiving long-term adefovir dipivoxil (ADV) treatment.We retrospectively enrolled 85 patients treated with ADV and 85 patients treated with entecavir (ETV) monotherapy, for at least 6 months. The 2 groups were matched for baseline age (± 5 years), sex, and estimated glomerular filtration rate (eGFR). Serum creatinine, cystatin C, and KIM-1 concentrations were measured, and eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-cystatin C equation, at baseline and last follow-up.eGFR decreased by 10-20% from baseline in 11/85 (14.1%) patients, 20-30% in 5/85 (5.9%), and ≥ 30% in 2/85 (2.4%) patients treated with ADV. Serum KIM-1 was more significantly increased after ADV treatment 86.53 (10.20-355.40) pg/mL than ETV treatment 61.54 (10.53-200.56) pg/mL (P < 0.01). Furthermore, serum KIM-1 was positively correlated with serum cystatin C (r = 0.47; P < 0.001) and negatively correlated with eGFR (r = -0.46; P < 0.001). The area under the receiver operating characteristic curve (AUC-ROC) of serum KIM-1 for identifying renal dysfunction in all enrolled patients was 0.94 (95% confidence interval [95% CI], 0.87 to 1.02; P < 0.001), while the AUC-ROC of serum creatinine was only 0.82 (95% CI, 0.60 to 1.03; P < 0.01).Serum KIM-1 is a promising new diagnostic biomarker of renal dysfunction during long-term ADV therapy for CHB patients.
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Hebei Medical University Department of Liver Disease, The Fifth Hospital of Shijiazhuang, Shijiazhuang, China.
authors.forename: Ziyue
authors.initials: Z
authors.lastname: Li
authors.forename: Chuan
authors.initials: C
authors.lastname: Shen
authors.forename: Yadong
authors.initials: Y
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhao
authors.forename: Zhenzhong
authors.initials: Z
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Caiyan
authors.initials: C
authors.lastname: Zhao
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced*; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D063065:Organophosphonates; C053001:adefovir; D000225:Adenine