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Combination therapy with lamivudine and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for hepatitis B virus-associated glomerulonephritis with mild to moderate proteinuria: a clinical review of 38 cases

  • Nephrology - Original Paper
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Abstract

Purpose

The treatment of HBV-associated glomerulonephritis (HBV-GN) is still a challenge in clinical practice now. The objective of this study was to report the pathological characteristics of HBV-GN presenting with mild to moderate proteinuria and to evaluate the therapeutic efficacy of lamivudine (LAM) in combination with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) as compared to ACEI/ARB monotherapy.

Methods

We conducted a retrospective observational study in HBV-GN patients between 2005 and 2014. The patients were classified into two groups: Group 1 included patients treated with LAM plus ACEI/ARB (n = 20), and group 2, patients treated with ACEI/ARB alone (n = 18). Their clinical and pathological characteristics were collected; we analyzed the therapeutic responses and assessed the correlation between renal and liver pathologies.

Results

Our results showed that the most common type of HBV-GN was IgA nephropathy. LAM plus ACEI/ARB therapy was better in reducing 24-h urinary protein excretion, alanine aminotransferase, and aspartate aminotransferase levels, while maintaining the level of kidney function. The proportion of patients who achieved remission (CR + PR) was higher in the LAM plus ACEI/ARB group than in the ACEI/ARB monotherapy group (χ 2 = 5.371, P = 0.035).

Conclusion

In the HBV-GN patients with mild to moderate proteinuria, LAM plus ACEI/ARB not only improved liver function but also better reduced 24-h proteinuria.

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Acknowledgements

The authors would like to thank all the participants in this study.

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Authors and Affiliations

  1. Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China

    Li-Jing Sun, Jian-Ping Shan & Geng-Ru Jiang

  2. Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China

    Li-Jing Sun, Ruo-Lan Cui & Wei-Jie Yuan

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  1. Li-Jing Sun
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  2. Jian-Ping Shan
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  3. Ruo-Lan Cui
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  4. Wei-Jie Yuan
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Correspondence to Li-Jing Sun.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Medicine Faculty of Changhai Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

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

Statement of animal studies

This article does not contain any studies with animals performed by any of the authors.

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Sun, LJ., Shan, JP., Cui, RL. et al. Combination therapy with lamivudine and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for hepatitis B virus-associated glomerulonephritis with mild to moderate proteinuria: a clinical review of 38 cases. Int Urol Nephrol 49, 1049–1056 (2017). https://doi.org/10.1007/s11255-017-1563-5

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  • DOI: https://doi.org/10.1007/s11255-017-1563-5

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