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2016 ; 2016
(ä): 2952635
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Nucleotide Analogue-Related Proximal Renal Tubular Dysfunction during Long-Term
Treatment of Chronic Hepatitis B: A Cross-Sectional Study
#MMPMID27872640
Sobhonslidsuk A
; Wanichanuwat J
; Numthavaj P
; Sophonsritsuk A
; Petraksa S
; Pugasub A
; Jittorntam P
; Kongsomgan A
; Roytrakul S
; Phakdeekitcharoen B
Gastroenterol Res Pract
2016[]; 2016
(ä): 2952635
PMID27872640
show ga
Background. There have been few reports of nucleotide analogue-related renal
tubular dysfunction (RTD) in CHB patients. We assessed the prevalence and
presentation of nucleotide analogue-related proximal RTD. Methods. A
cross-sectional study was performed in CHB patients taking nucleotide analogues.
Inclusion criteria were patients who were on adefovir or tenofovir as mono- or
add-on therapy with lamivudine (LAM) >1 year. Serum and urine were collected.
Fractional excretion of phosphate (FEPO(4)), uric acid (FEUA), and potassium was
calculated. Renal losses were defined based on the criteria: protein (24-hour
urine protein >150?mg), glucose (glycosuria with normoglycemia), phosphate
(FEPO(4) >18%), uric acid (FEUA >15%), potassium (renal potassium losses with
hypokalemia), and bicarbonate (normal gap acidosis). Subclinical and overt
proximal RTD were defined when 2 and ?3 criteria presented. Results. Ninety-two
patients were enrolled. The mean duration of nucleotide analogue taking was 55.1
± 29.6 months. Proximal RTD was found in 24 (26.1%) patients (subclinical 15
(16.3%) and overt 9 (9.8%)). The severity of RTD was associated with the duration
of nucleotide analogue (P = 0.01). Conclusions. The prevalence of proximal RTD in
CHB patients taking nucleotide analogues was 26%. The severity of RTD was
associated with the treatment duration. Comprehensive testing is necessary for
early detecting nucleotide analogue-related nephrotoxicity.