Renal profile of chronic hepatitis C patients with sofosbuvir-based therapy
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ORIGINAL PAPER
Renal profile of chronic hepatitis C patients with sofosbuvir‑based therapy Mohammad El‑Sayed1 · Zeinab Abdellatif1 · Aisha Elsharkawy1 · Mohamed El Kassas2 · Reham Abd Elmoniem1 · Amaal Marzouk3 · Rabab Fouad1 · Gamal Esmat1,4 · Shereen Abdel Alem1 Received: 28 May 2020 / Accepted: 12 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The impact of SOF-based therapy on renal functions is quite controversial in clinical practice. Therefore, we aimed to evaluate the serial changes of renal indices during SOF-based therapy in CHC patients with normal kidney function or mild renal impairment. Methods We retrospectively reviewed all CHC patients who received different SOF-based regimens from January 2015 until December 2017, and presented with a baseline eGFR ≥ 30 ml/min/1.73m2. Patients who didn’t achieve SVR, with missing creatinine or eGFR data, and patients with eGFR less than 30 ml/min/1.73m2 at baseline were excluded. eGFR was calculated for each time of evaluation using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Results A total of 1004 patients were finally included. The mean serum creatinine and eGFR levels varied between 0.84 mg/ dl and 106.53 ml/min/1.73m2 for baseline and 0.87 mg/dl and 104.24 ml/min/1.73m2 for SVR12, respectively. The maximum increase of creatinine was 3.69 mg/dl and the maximum decrease of eGFR level was 83.30 ml/min/1.73m2 during treatment. Moreover, 74.4% of treated patients stayed in the same eGFR category, 14.3% progressed to a higher eGFR category, and 11.3% had an improvement eGFR category at EOT and continued to SVR12. Age > 65 years, baseline eGFR, and ribavirin– containing regimens were independent risk factors of eGFR decline during and after SOF-based treatment. Conclusion SOF-based therapies seem to be safe in CHC patients with baseline normal or slightly impaired renal function. Keywords Hepatitis C virus · Estimated glomerular filtration · Normal renal functions · Sofosbuvir-based treatment · Sustained virological response
Introduction Hepatitis C virus (HCV) infection is widespread, with 71 million individuals suffering from CHC [1]; these individuals are at high risk for progressive liver disease including liver cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC) and death. Chronic HCV infection is associated * Shereen Abdel Alem [email protected] 1
Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
2
Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
3
Endemic Medicine Department, Abbassia Fever Hospital, Ministry of Health and Population, Cairo, Egypt
4
Department of Research Development, Badr University, Cairo, Egypt
with extrahepatic manifestations and targets multiple organ systems other than the liver such as the kidney via either an immune cascade or a cytopathic effect [2]. With the development of direct-acting antiviral agents (DAAs), excellent cure rates were
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