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Efficacy and safety of entecavir for hepatitis B virus-associated glomerulonephritis with renal insufficiency

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Abstract

Background

HBV-GN is one of the most common secondary kidney diseases in China. Entecavir is a first-line antiviral therapy in patients with HBV-GN.

Objective

This retrospective study explored whether entecavir is effective and safe for the treatment of HBV-GN with renal insufficiency.

Methods

We screened patients diagnosed with HBV-GN in The Affiliated Hospital of Qingdao University who had elevated serum creatinine levels. Group 1 (30 patients) was given entecavir as antiviral treatment. Group 2 (28 patients) was treated with ARBs. Changes in renal function and the possible influencing factors were observed, with a mean follow-up duration of 36 months.

Results

At the end of follow-up, the elevation in the serum creatinine level and reduction in the eGFR were greater in group 1 than in group 2. The overall renal survival rate, using eGFR < 15 ml/min as the primary renal end point, was 96.7% in group 1 and 67.9% in group 2. Urine protein excretion was decreased in both groups. Treatment with entecavir and the remission of proteinuria were protective factors against renal function impairment, while a lower baseline eGFR was a risk factor for progression to ESRD.

Conclusions

Entecavir slows the progression of renal function impairment in HBV-GN and exerts a significant renal protective effect.

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Data availability

All data generated or analysed during this study are included in this article.

Change history

Abbreviations

HBV-GN:

Hepatitis B virus-associated glomerulonephritis

ARBs:

Angiotensin II receptor blockers

eGFR:

Estimated glomerular filtration rate

ESRD:

End-stage renal disease

HBV:

Hepatitis B virus

CHB:

Chronic hepatitis B

SLE:

Systemic lupus erythematosus

HCC:

Hepatocellular carcinoma

IF:

Immunofluorescence

EASL:

European Association for the Study of the Liver

AASLD:

American Association for the Study of Liver Diseases

CDC:

Chinese Center for Disease Control and Prevention

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Acknowledgements

We thank the staff members at The Affiliated Hospital of Qingdao University and The 971th Hospital of PLA for their help. This study was funded by the National Natural Science Foundation of China (NSFC 81870494), the Chinese Society of Nephrology (20010080800) and the Qingdao Outstanding Health Professional Development Fund (2020–2022).

Funding

This study was funded by the National Natural Science Foundation of China (NSFC 81870494), the Chinese Society of Nephrology (20010080800) and the Qingdao Outstanding Health Professional Development Fund (2020–2022).

Author information

Author notes

  1. Yani Yu, Lingyu Xu and Ting Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, China

    Yani Yu, Lingyu Xu, Chengyu Yang, Quandong Bu, Wei Zhang, Long Zhao, Yan Xu & Wei Jiang

  2. Department of Gerontology, The 971th Hospital of PLA, Qingdao, 266071, Shandong, China

    Ting Xu

Authors
  1. Yani Yu
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  2. Lingyu Xu
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  3. Ting Xu
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  6. Wei Zhang
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  7. Long Zhao
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  8. Yan Xu
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  9. Wei Jiang
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Contributions

YY, LX and TX wrote the main manuscript text. WZ and LZ collected the clinical study information. CY completed the formal analysis and investigation. YX and WJ prepared Figs. 1, 2, 3, 45 and 6. All authors reviewed the manuscript.

Corresponding author

Correspondence to Wei Jiang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

Approval was granted by The Affiliated Hospital of Qingdao University. All methods were performed in accordance with the relevant guidelines and regulations.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Informed consent was obtained from all authors of the study.

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The original online version of this article was revised:In the original publication, the fig 1e has been published incorrectly.

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Yu, Y., Xu, L., Xu, T. et al. Efficacy and safety of entecavir for hepatitis B virus-associated glomerulonephritis with renal insufficiency. Clin Exp Nephrol 27, 680–686 (2023). https://doi.org/10.1007/s10157-023-02351-z

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  • DOI: https://doi.org/10.1007/s10157-023-02351-z

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