Publication:

Is tenofovir disoproxil nephrotoxic in all patients? side effects of tenofovir and entecavir on kidney

Background Hepatit B virus (HBV) is one of the main causes of liver related morbidity and mortality in worldwide. This condition is also a significant healthcare problem in Turkey. Entecavir (ETV) and tenofovir (TDF) are potent nucleos(t)ide analogues (NAs) recommended for the treatment of chronic HBV (CHB) infection. The aim of the study was to determine the association of NAs and nephrotoxicity in our CHB cohort.

Methods Between the January 2011-February 2021, there were 294 patients treated with TDF (N=194) and ETV (N=100). Glomerular filtration rate (GFR) was calculated by the modification of diet in renal disease (MDRD) method. Kidney function tests were assessed at baseline and follow-up visits.

Results There were 294 patients in the total group. The mean follow-up period was 66±18 months. Age and sex distributions and baseline assessments including liver function tests, creatinine, GFR, HBV DNA values and pathology scores (HAI and fibrosis) were similar between TDF (N=194) and ETV (N=100) groups. Creatinin and GFR assessed at the last visit were 0.81±0.01 g/dl and 102.94±19.78 ml/min for TDF and 0.81±0.013 g/dl and 104.65±19.05 ml/min for ETV. These values were not significant between the both treatment groups. In terms of nephrotoxicity, none of the patients had significant changes in terms of creatinine and GFR that may require dose adjustment.

Conclusions We showed that the use of both drugs led to a decrease in GFR that was not clinically important in chronic hepatitis B patients with normal baseline renal tests and without co-morbidity.