Investigation And Risk Factors Of Renal Function In Patients With Chronic Hepatitis B Treated By Nucleotide Antiviral Drug

Objective: To understand the abnormal renal function in patients with chronic hepatitis B virus infection and analyze the risk factors.Methods: In November 2013 and 2015,October in our hospital inpatient treatment and September 2015 December 2015 chronic hepatitis B patients in clinic were collected.They were divided into adefovir dipivoxil group(ADV group),lamivudine combined with adefovir dipivoxil group(ADV/LAM group),entecavir group(ETV group)and lamivudine group(LAM group).The e-GFR value of the patients was estimated by using the simplified kidney disease diet adjustment working group(MDRD)equation,then we calculated the rate of abnormal renal function(e-GFR<90ml/min/1.73m2),and two Logistic regression analysis of single factor classification and two Logistic regression analysis of multiple factors were performed on the high risk factors.Results:1.216 cases were collected in this study.The overall rate of abnormal renal function was 19.9%(43/216),and the abnormal rate of renal function of the four groups were 31%,33.3%,13.2%,13.8%,respectively,the difference was statistically significant(X2=10.613,P=0.014),while pairwise comparison between groups were not statistically significant(P>0.008).The renal dysfunction rate in ADV group and ADV/LAM group were significantly higher than that of LAM group and ETV groups,the difference was statistically significant(ADV+ADV/LAM vs LAM+ETV X2=10.537,P=0.001).2.Multivariate binary logistic regression analysis results suggested that adefovir dipivoxil(OR=6.370,P = 0.002)and adefovir dipivoxil combined with lamivudine(OR=4.945,P = 0.008)and age(OR=1.060,P = 0.004),diabetes mellitus(OR=4.221,P = 0.012)were the abnormal renal function of significant risk factors.Conclusion: Long-term use of nucleotide antiviral treatment of chronic hepatitis B patients,especially taking adefovir dipivoxil monotherapy or adefovir dipivoxil combined with lamivudine therapy in elderly patients,renal function should be monitored closely,in order to find the early renal insufficiency.