Renal tubular dysfunction during long-term adefovir or tenofovir therapy in chronic hepatitis B
Alimentary Pharmacology and Therapeutics,  Clinical Article

Gara N et al. – Renal tubular dysfunction develops in 15% of patients treated with adefovir or tenofovir for 2–9 years and is partially reversible with change to other antivirals. Monitoring for serum phosphate, creatinine and urinalysis is prudent during long–term adefovir and tenofovir therapy.

Methods
  • A total of 51 patients being treated at the Clinical Center, National Institutes of Health were studied.
  • Diagnosis of RTD required de novo appearance of at least three of five features: hypophosphataemia, hypouricaemia, serum creatinine elevation, proteinuria or glucosuria.

Results
  • Among 51 patients treated for 1-10 (mean 7.4) years with adefovir (n=42), tenofovir (n=4) or adefovir followed by tenofovir (n=5), 7 (14%) developed RTD.
  • Time to onset ranged from 22 to 94 (mean 49) months with an estimated 10-year cumulative rate of 15%.
  • All seven had low urinary percent maximal tubular reabsorption of phosphate (<82%).
  • Patients with RTD were older (58 vs. 44 years; P=0.01) and had lower baseline glomerular filtration rates (82 vs. 97 cc/min; P = 0.08) compared to those without; but did not differ in other features.
  • Six patients with RTD were switched to entecavir, all subsequently had improvements in serum phosphate (2.0-3.0 mg/dL), creatinine (1.6-1.1 mg/dL), uric acid (2.7-3.8 mg/dL) and proteinuria.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Gastroenterology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Gastroenterology Articles

1 Fecal lactoferrin in discriminating inflammatory bowel disease from irritable bowel syndrome: A diagnostic meta-analysis Full Text BMC Gastroenterology, July 14, 2014    Free full text    Evidence Based Medicine

2 Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis Clinical Gastroenterology and Hepatology , June 25, 2014    Evidence Based Medicine    Clinical Article

3 The vitamin D status in inflammatory bowel disease PLOS ONE, July 18, 2014    Clinical Article
Exclusive Author Commentary

4 Why, when and how to de-escalate therapy in inflammatory bowel diseases Alimentary Pharmacology and Therapeutics, July 2, 2014    Review Article

5 Comparing omeprazole with fluoxetine for treatment of patients with heartburn and normal endoscopy who failed once daily proton pump inhibitors: Double-blind placebo-controlled trial Neurogastroenterology & Motility, February 10, 2014    Clinical Article

6 Subcutaneous ustekinumab for the treatment of anti-TNF resistant Crohn's disease-The McGill experience Journal of Crohn's and Colitis, July 9, 2014    Clinical Article

7 Daikenchuto, a traditional Japanese herbal medicine, for the maintenance of surgically induced remission in patients with Crohn's disease: a retrospective analysis of 258 patients Surgery Today, July 21, 2014    Clinical Article

8 Serological markers associated with disease behavior and response to anti-TNF therapy in ulcerative colitis Journal of Gastroenterology and Hepatology, July 15, 2014    Clinical Article

9 Effect of a low-flatulogenic diet in patients with flatulence and functional digestive symptoms Neurogastroenterology & Motility, February 25, 2014    Clinical Article
Exclusive Author Commentary

10 Safety of gastrointestinal endoscopic biopsy in patients taking antithrombotics Digestive Endoscopy, May 5, 2014    Clinical Article

11 Smoking behaviour modifies IL23R-Crohn's disease risk in patients with Crohn's disease Journal of Gastroenterology and Hepatology, July 16, 2014    Clinical Article

12 Family history of inflammatory bowel disease among patients with ulcerative colitis: A systematic review and meta-analysis Journal of Crohn's and Colitis, July 7, 2014    Evidence Based Medicine    Review Article

13 A prospective, randomized, controlled, exploratory study of comprehensive dietary advice in ulcerative colitis: impact on disease activity and quality of life European Journal of Gastroenterology & Hepatology, July 10, 2014    Clinical Article

14 Placebo analgesia in patients with functional and organic abdominal pain: a fMRI study in IBS, UC and healthy volunteers Gut, July 8, 2014    Clinical Article

15 Factors associated with pregnancy outcome in anti-TNF treated women with inflammatory bowel disease Alimentary Pharmacology and Therapeutics, July 3, 2014    Clinical Article

16 Impact of surveillance of hepatitis B and hepatitis C in patients with inflammatory bowel disease under anti-TNF therapies: Multicenter prospective observational study (REPENTINA 3) Journal of Crohn's and Colitis, July 30, 2014    Clinical Article

17 Escalation to weekly dosing recaptures response in adalimumab-treated patients with moderately to severely active ulcerative colitis Alimentary Pharmacology and Therapeutics, July 23, 2014    Clinical Article

18 Risk and management of intra-abdominal abscess in Crohn's disease treated with infliximab Digestion, May 2, 2014    Clinical Article

19 Increased risk of venous thromboembolic events with corticosteroid vs biologic therapy for inflammatory bowel disease Clinical Gastroenterology and Hepatology , July 25, 2014    Clinical Article

20 Adalimumab drug and antibody levels as predictors of clinical and laboratory response in patients with Crohn's disease Alimentary Pharmacology and Therapeutics, July 28, 2014    Clinical Article

Indexed Journals in Gastroenterology: Gastroenterology, American Journal of Gastroenterology, Gutmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close