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The frequency of acute kidney injury in patients with chronic hepatitis C virus infection treated with sofosbuvir‐based regimens
Author(s) -
Maan R.,
Al Marzooqi S. H.,
Klair J. S.,
Karkada J.,
Cerocchi O.,
Kowgier M.,
Harrell S. M.,
Rhodes K. D.,
Janssen H. L. A.,
Feld J. J.,
DuarteRojo A.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14117
Subject(s) - medicine , sofosbuvir , telaprevir , boceprevir , regimen , acute kidney injury , renal function , creatinine , gastroenterology , hepatitis c virus , ribavirin , immunology , virus
Summary Background Guidelines recommend withholding sofosbuvir ( SOF ) in patients with an estimated glomerular filtration rate ( eGFR ) of less than 30 mL/min. Aim To assess the risk of acute kidney injury ( AKI ) in patients with no renal contraindications for SOF ‐based treatment. Methods This multicenter retrospective observational study included all consecutive patients that were treated with SOF ‐based or telaprevir/boceprevir (TVR/BOC)‐based regimens at two tertiary university centers in North America. AKI was defined as an increase of ≥0.3 mg/ dL (≥26.5 μmol/L) in serum creatinine level. Multivariable logistic regression analysis was used to identify risk factors for the occurrence of AKI . Results In total, 426 patients were included and treated with a SOF ‐based regimen (n=233, 54.7%) or TVR / BOC ‐based regimen (n=193, 45.3%). Among patients treated with a TVR / BOC ‐based regimen 34 (18%) of 193 patients experienced AKI compared to 26 (11%) of 233 patients treated with SOF ‐based regimens ( P =.056). Multivariable logistic regression analysis showed that the presence of ascites ( OR : 4.44, 95% CI : 1.46‐13.54, P =.009) and the use of NSAID s ( OR : 4.47, 95% CI : 1.32‐15.19, P =.016) were associated with a risk of AKI during SOF ‐based antiviral therapy. Creatinine levels returned to normal at end of follow‐up in 23 (88%) of the 26 patients who experienced AKI with a SOF‐based regimen and had a creatinine level available during follow‐up. Conclusions Although the risk for AKI was lower than for patients treated with TVR / BOC ‐based regimens, AKI was seen during 11% of SOF ‐based regimens and was mostly reversible. Patients with ascites and patients using NSAID s have an increased risk for AKI during SOF ‐based antiviral therapy.