Clin Mol Hepatol.
2018 Jun;24(2):151-162. 10.3350/cmh.2017.0059.
Evolution of glomerular filtration rates and neutrophil gelatinase-associated lipocalin during treatment with direct acting antivirals
- Strazzulla A
- Coppolino
- Barreca GS
- Gentile I
- Rivoli L
- Postorino
- Mazzitelli M
- Greco G
- Costa C
- Pisani V
- Marascio N
- Simeoni M
- Focà A
- Fuiano G
- Foti D
- Gulletta E
- Torti C
- Affiliations
-
- 1Division of Infectious Diseases, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. alessiostrazzulla@yahoo.it
- 2Division of Nephrology and Dialysis, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
- 3Division of Microbiology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
- 4Division of Clinical Pathology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
- 5Division of Nephrology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
- KMID: 2417062
- DOI: http://doi.org/10.3350/cmh.2017.0059
Abstract
- BACKGROUND/AIMS
Correct renal function evaluation is based on estimated glomerular filtration rates (eGFR) and complementary renal damage biomarkers, such as neutrophil gelatinase associated lipocalin (NGAL). The aim of this study was to evaluate eGFR and NGAL modifications and renal impairment during treatment with a direct acting antiviral (DAA) for chronic hepatitis C virus (HCV) infection.
METHODS
A retrospective cohort study evaluated eGFR modification during treatment with DAA. Subgroup analysis on serum NGAL was conducted in those receiving sofosbuvir/ledipasvir, with complete follow-up until week 12 after the end of treatment (FU-12).
RESULTS
In the 102 enrolled patients, eGFR reduction was observed (from 86.22 mL/min at baseline to 84.43 mL/min at FU-12, P=0.049). Mean NGAL increased in 18 patients (from 121.89 ng/mL at baseline to 204.13 ng/mL at FU-12, P=0.014). At FU-12, 38.8% (7/18) of patients had a plasmatic NGAL value higher than the normal range (36-203 ng/mL) compared with 11.1% (2/18) at baseline (χ2 =3,704; P=0.054). In contrast, eGFR did not change significantly over the follow-up in this subgroup.
CONCLUSIONS
In conclusion, compared to a negligible eGFR decline observed in the entire cohort analyzed, a significant NGAL increase was observed after HCV treatment with DAA in a small subgroup. This could reflect tubular damage during DAA treatment rather than glomerular injury.
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