Clin Mol Hepatol.
2016 Jun;22(2):286-291. 10.3350/cmh.2015.0066.
Tenofovir-associated nephrotoxicity in patients with chronic hepatitis B: two cases
- Affiliations
-
- 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. yoonjun@snu.ac.kr
- 2Nephrology Division, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
- 4Gastroenterohepatology Division, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia.
- KMID: 2373127
- DOI: http://doi.org/10.3350/cmh.2015.0066
Abstract
- Tenofovir disoproxil fumarate (TDF) is effective against chronic hepatitis B (CHB) infection and its use is increasing rapidly worldwide. However, it has been established that TDF is associated with renal toxicity in human immunodeficiency virus-infected patients, while severe or symptomatic TDF-associated nephrotoxicity has rarely been reported in patients with CHB. Here we present two patients with TDF-associated nephrotoxicity who were being treated for CHB infection. The first patient was found to have clinical manifestations of proximal renal tubular dysfunction and histopathologic evidence of acute tubular necrosis at 5 months after starting TDF treatment. The second patient developed acute kidney injury at 17 days after commencing TDF, and he was found to have membranoproliferative glomerulonephritis with acute tubular injury. The renal function improved in both patients after discontinuing TDF. We discuss the risk factors for TDF-associated renal toxicity and present recommendations for monitoring renal function during TDF therapy.
Keyword
MeSH Terms
-
Acute Kidney Injury/etiology
Aged
Antiviral Agents/adverse effects/therapeutic use
Creatinine/blood
Glomerular Filtration Rate
Hepatitis B, Chronic/*drug therapy
Humans
Kidney Tubules/pathology
Male
Microscopy, Electron
Middle Aged
Necrosis
Risk Factors
Tenofovir/adverse effects/*therapeutic use
Antiviral Agents
Creatinine
Tenofovir
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