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Tenofovir does not induce renal dysfunction compared to entecavir in post-liver-transplant hepatitis B virus patients

Annals of Surgical Treatment and Research 2020년 99권 3호 p.180 ~ 187
김상진, 유진수, Lee Seo-Hee, 김종만, 최규성, 김경아, 조재원,
소속 상세정보
김상진 ( Kim Sang-Jin ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
유진수 ( Rhu Jin-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Lee Seo-Hee ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김종만 ( Kim Jong-Man ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
최규성 ( Choi Gyu-Seong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김경아 ( Kim Kyung-A ) - Samsung Medical Center Research Institute for Future Medicine Statistics and Data Center
조재원 ( Joh Jae-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

Abstract


Purpose: Tenofovir disoproxil fumarate is accepted as an effective and tolerable drug for treatment of HBV, similar to entecavir. However, there are some concerns about the nephrotoxicity of tenofovir. The aim of this study is to compare the renal-function change of liver recipients who received tenofovir or entecavir for HBV.

Methods: Among 468 patients with HBV who underwent liver transplantation at Samsung Medical Center between January 2008 and December 2015, the patients treated with tenofovir (n = 39) or entecavir (n = 429) were reviewed retrospectively. Baseline characteristics and renal-function change after 1 month, 1 year, and 2 years were compared. Propensity-score matching was performed for 37 patients using tenofovir and 132 patients using entecavir. We also analyzed risk factors of renal dysfunction.

Results: Age, preoperative creatinine, estimated glomerular filtration rate (e-GFR), and hepatic encephalopathy score showed statistical difference between the tenofovir and entecavir groups. The proportion of patients with ‘decreased renal function (e-GFR < 60 mL/min/1.73 m2)’ was higher in the tenofovir group than in the entecavir group (33.3% vs. 12.4% at postoperative one year, P < 0.005). After propensity-score matching, there was no statistical difference in preoperative characteristics. Postoperative 1-, 2-, and 3-year e-GFR and creatinine showed no statistical difference in either group. On multivariate analysis, only preoperative high e-GFR showed a protective effect on renal-function change (odds ratio, 0.97; P < 0.001), and there was no aggravating factor.

Conclusion: Tenofovir disoproxil fumarate does not induce renal dysfunction in liver-transplanted patients with HBV more than does entecavir.

키워드

Entecavir; Renal insufficiency; Tenofovir; Transplantation

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