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Telbivudine improves renal function in patients with chronic hepatitis B
Edward J Gane1, Gilbert Deray2, Yun-Fan Liaw3
1Auckland City Hospital, Auckland, New Zealand.
Long-term telbivudine therapy improved renal function in patients with chronic hepatitis B virus infection and liver disease. This benefit was sustained, especially in those at higher risk for kidney impairment.
Area of Science:
- Hepatology
- Nephrology
- Virology
Background:
- Chronic hepatitis B virus infection is linked to chronic kidney disease.
- Assessing renal function is crucial in managing hepatitis B patients.
Purpose of the Study:
- To analyze changes in renal function markers during telbivudine treatment for chronic hepatitis B virus infection.
- To evaluate the impact of telbivudine on estimated glomerular filtration rate (eGFR) in diverse patient groups.
Main Methods:
- Utilized serum creatinine-based equations (Cockcroft-Gault, MDRD, CKD-EPI) to estimate GFR.
- Analyzed data from a 2-year phase III study (GLOBE) and long-term extensions (4-6 years).
- Included patients with compensated and decompensated cirrhosis, some with high renal risk.
Main Results:
- Telbivudine treatment led to a significant increase in mean eGFR (8.5% by MDRD) over 2 years, sustained long-term.
- Renal function improved in telbivudine-treated patients, including those with baseline eGFRs of 60-89 mL/min/1.73 m(2), older than 50, and with liver fibrosis/cirrhosis.
- Decompensated patients with high renal risk also showed improved eGFR (+2.0%) with telbivudine.
Conclusions:
- Long-term telbivudine therapy demonstrates sustained renal function improvement in patients with chronic hepatitis B and cirrhosis.
- The renal protective effect was particularly notable in patients at increased risk for renal impairment.
- The underlying mechanisms for telbivudine's renal protective effect require further investigation.
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