title: Relationship between nephrotoxicity and long-term adefovir dipivoxil therapy for chronic hepatitis B: A meta-analysis.
abstract: BACKGROUND
  To assess the relationship between adefovir dipivoxil and renal function after anti-hepatitis B virus therapy and elucidate the risk factors involved.
  
  
  METHODS
  Based on the requirements of the Cochrane systematic review methodology, 21 observational articles on adefovir dipivoxil-associated renal dysfunction were obtained by searching various databases, between January 1, 1995 and July 1, 2016. The Newcastle Ottawa Scale was used to evaluate risk bias. Parameters for 4276 chronic hepatitis B patients were analyzed by Review Manager and R software, and glomerular filtration rate, creatinine clearance, and serum creatinine values were extracted to evaluate renal function.
  
  
  RESULTS
  Renal dysfunction was more likely to occur in patients receiving the adefovir dipivoxil therapy (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.40-2.80) than the none-adefovir dipivoxil group. Subgroup analysis showed that renal function predictive value is higher for glomerular filtration rate (OR 2.42, 95% CI 1.34-3.14), compared with serum creatinine levels (OR 1.51, 95% CI 0.75-3.04). The rate of adefovir dipivoxil-associated renal dysfunction was 12% (95% CI 0.08-0.16). Older patients and patients with renal insufficiency, hypertension, and diabetes mellitus were more prone to developing adefovir dipivoxil-associated renal dysfunction; however, integrated raw data were insufficient for further detailed analysis.
  
  
  CONCLUSIONS
  Long-term adefovir dipivoxil therapy is connected to renal dysfunction in chronic hepatitis B, necessitating the monitoring of kidney function.
authors.affiliation: Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University Department of Gastroenterology, Chongqing General Hospital Department of Endocrinology and Metabolism Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Luo
authors.forename: Yong
authors.initials: Y
authors.lastname: Deng
authors.forename: Feifei
authors.initials: F
authors.lastname: Cheng
authors.forename: Juan
authors.initials: J
authors.lastname: Kang
authors.forename: Shan
authors.initials: S
authors.lastname: Zhong
authors.forename: Dazhi
authors.initials: D
authors.lastname: Zhang
authors.forename: Weiqiong
authors.initials: W
authors.lastname: Zeng
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D005919:Glomerular Filtration Rate / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007674:Kidney Diseases / Q000139:chemically induced*; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors
chemical_list: D063065:Organophosphonates; D003404:Creatinine; D000225:Adenine; C106812:adefovir dipivoxil