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Tenofovir and Entecavir Have Similar Renal Adverse Events on Hepatocellular Carcinoma Patients Treated with Transarterial Chemoembolization

대한간암학회지 2019년 19권 2호 p.128 ~ 135
 ( Cho Young-Youn ) - Seoul National University College of Medicine Department of Internal Medicine

 ( Choi Young-Hwan ) - Chung-Ang University Hospital Department of Internal Medicine
 ( Yu Su-Jong ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Cho Eun-Ju ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Lee Jeong-Hoon ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Kim Yoon-Jun ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Yoon Jung-Hwan ) - Seoul National University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Tenofovir disoproxil fumarate (TDF) is potentially nephrotoxic in chronic hepatitis B patients. Hepatocellular carcinoma (HCC) patients treated using transarterial chemoembolization (TACE) are at an increased risk of renal injury. The aim of this study was to determine whether TDF is associated with more renal adverse events than entecavir (ETV) in HCC patients treated with TACE.

Methods: In this retrospective single-center study, we selected 53 HCC patients who were treated with TDF from January 2012 to July 2013 and had their first TACE procedure in the same period. These patients were matched by age and sex to patients treated with ETV.

Results: There were no significant differences in baseline characteristics, including HCC factors, and nephrotoxic drug use, between the two groups. The median follow-up period was 17.0 and 20.0 months for the TDF and ETV groups, respectively. There was no difference during the follow-up period between the TDF and ETV groups in the increase in creatinine over 0.5 mg/dL (17.0% and 17.0%,P=1.00, respectively) and the decrease in eGFR over 25% (43.4% and 41.5%,P=0.84, respectively). Multivariate analysis revealed that Child-Pugh class over B (hazard ratio [HR], 7.30; 95% confidence interval [CI] 2.79-19.10;P<0.01) was associated with increase in creatinine, and Child-Pugh class over B (HR, 82.74; 95% CI 12.31-555.83;P<0.01) and Barcelona-Clinic Liver Cancer stage over B (HR, 14.93; 95% CI 1.60-139.51;P=0.02) were associated with decrease in eGFR.

Conclusions: TDF has comparable safety to that of ETV for HCC patients undergoing TACE.

키워드

Hepatocelluar carcinoma; Transarterial chemoembolization; Hepatitis B, chronic; Kidney diseases; Antiviral agents
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