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Nucleotide Analogue-Related Proximal Renal Tubular Dysfunction during Long-Term Treatment of Chronic Hepatitis B: A Cross-Sectional Study
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Metadata
Document Title
Nucleotide Analogue-Related Proximal Renal Tubular Dysfunction during Long-Term Treatment of Chronic Hepatitis B: A Cross-Sectional Study
Author
Sobhonslidsuk A, Wanichanuwat J, Numthavaj P, Sophonsritsuk A, Petraksa S, Pugasub A, Jittorntam P, Kongsomgan A, Roytrakul S, Phakdeekitcharoen B
Name from Authors Collection
Affiliations
Mahidol University; Mahidol University; Mahidol University; Mahidol University; Mahidol University; National Science & Technology Development Agency - Thailand; National Center Genetic Engineering & Biotechnology (BIOTEC); Mahidol University
Type
Article
Source Title
GASTROENTEROLOGY RESEARCH AND PRACTICE
ISSN
1687-6121
Year
2016
Volume
2016
Issue
4
Open Access
Green Published, Green Submitted, gold
Publisher
HINDAWI LTD
DOI
10.1155/2016/2952635
Format
Abstract
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 (FEPO4), uric acid (FEUA), and potassium was calculated. Renal losses were defined based on the criteria: protein (24-hour urine protein > 150mg), glucose (glycosuria with normoglycemia), phosphate (FEPO4 > 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.
Funding Sponsor
Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Gastroenterological Association of Thailand
Publication Source
WOS