Publication: Reversal of proximal renal tubular dysfunction after nucleotide analogue withdrawal in chronic Hepatitis B
Issued Date
2017-01-01
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23146141
23146133
23146133
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2-s2.0-85042151280
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Mahidol University
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SCOPUS
Bibliographic Citation
BioMed Research International. Vol.2017, (2017)
Suggested Citation
Abhasnee Sobhonslidsuk, Pawin Numthavaj, Jirachaya Wanichanuwat, Areepan Sophonsritsuk, Supanna Petraksa, Alongkorn Pugasub, Paisan Jittorntam, Anucha Kongsomgan, Sittiruk Roytrakul, Bunyong Phakdeekitcharoen Reversal of proximal renal tubular dysfunction after nucleotide analogue withdrawal in chronic Hepatitis B. BioMed Research International. Vol.2017, (2017). doi:10.1155/2017/4327385 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/42077
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Title
Reversal of proximal renal tubular dysfunction after nucleotide analogue withdrawal in chronic Hepatitis B
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Abstract
Copyright © 2017 Abhasnee Sobhonslidsuk et al. Aims. Proximal renal tubular dysfunction (PRTD) is an infrequent complication after nucleotide analogue therapy.We evaluated the outcomes of PRTD and nephrotoxicity after nucleotide analogue withdrawal in chronic hepatitis B (CHB). Methods. A longitudinal follow-up study was performed in patients with PRTD after nucleotide analogue discontinuation. Serum and urine were collected at baseline and every 3 months for one year. The fractional excretion of phosphate (PO4), uric acid (UA), and potassium and tubular maximal reabsorption rate of PO4 to glomerular filtration rate (TmPO4/GFR) were calculated. Renal losses were defined based on the criteria of substance losses. Subclinical PRTD and overt PRTD were diagnosed when 2 and =3 criteria were identified. Results. Eight subclinical and eight overt PRTD patients were enrolled. After nucleotide analogue withdrawal, there were overall improvements in GFR, serum PO4, and UA. Renal loss of PO4, UA, protein, and ß2-microglobulin reduced over time. At one year, complete reversal of PRTD was seen in 13 patients (81.2%). Improvements in PRTD were seen in all but one patient. Conclusion. One year after nucleotide analogue withdrawal, PRTD was resolved in most patients. Changes in TmPO4/GFR, urinary protein, and ß2-microglobulin indicate that urinary biomarkers may represent an early sign of PRTD recovery.