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Effect of Direct-acting Antivirals Treatment on Renal Function Among HCV-infected Patients
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 45, Issue 1, Pages: 146-151(2024)
- 作者机构：
中山大学附属第三医院感染科，广东 广州，510630
- 作者简介：
LIN Chaoshuang； E-mail： lchaosh@mail.sysu.edu.cn
- 基金信息：
DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240005.001
CLC： R512.6Published：20 January 2024，
Received：12 July 2023，
Accepted：29 September 2023
扫 描 看 全 文
李梦月,李舣婷,张英等.慢性丙型肝炎直接抗病毒治疗对肾脏功能的影响[J].中山大学学报（医学科学版）,2024,45(01):146-151.
LI Mengyue,LI Yiting,ZHANG Ying,et al.Effect of Direct-acting Antivirals Treatment on Renal Function Among HCV-infected Patients[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(01):146-151.
李梦月,李舣婷,张英等.慢性丙型肝炎直接抗病毒治疗对肾脏功能的影响[J].中山大学学报（医学科学版）,2024,45(01):146-151. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240005.001.
LI Mengyue,LI Yiting,ZHANG Ying,et al.Effect of Direct-acting Antivirals Treatment on Renal Function Among HCV-infected Patients[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(01):146-151. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240005.001.
摘要
目的
2
探究慢性丙型肝炎患者经DAAs治疗后肾脏功能的变化。
方法
2
纳入自2017年1月至2021年12月于中山大学附属第三医院门诊就诊的经DAAs治疗的123例慢丙肝患者，分别收集治疗前、治疗期间、治疗结束后的血清肌酐值，通过MDRD公式估计eGFR，以评估患者完成直接抗病毒药物治疗后肾脏功能的变化。
结果
2
本研究纳入了123例患者，67.5%（
n
=83）为男性患者，平均年龄为（50±11）岁，中位随访时间为24周，26.8%（
n
=33）基线时存在肝硬化，10.6%（
n
=13）合并有糖尿病，11.4% （
n
=14）的患者eGFR
<
60 mL/（min ·1.73 m
2
），33.3% （
n
=41）的患者eGFR为 （60-89） mL/（min ·1.73 m
2
），55.3% （
n
=68）的患者eGFR≥90 mL/（min ·1.73 m
2
）。所有患者在治疗结束时及治疗结束后随访过程中eGFR并未出现下降，而CKD2期患者的eGFR在治疗结束后随访过程中较基线出现改善【（88.65±15.52） mL/（min ·1.73 m
2
）
vs
（78.12±7.60）mL/（min ·1.73 m
2
），
P
<
0.001】。14.6%（
n
=18）的患者经历了肾功能分期的恶化，通过二元logistic分析得出糖尿病可以预测肾功能的恶化（OR=4.663，
P
=0.016）。
结论
2
慢性丙型肝炎患者经DAAs治疗后，肾脏功能并未发生恶化，甚至在CKD2期的患者中发现肾脏功能有所改善。但慢丙肝合并糖尿病的患者发生肾脏功能恶化的风险高，仍需密切监测肾脏功能。
Abstract
；
Objective
2
To explore the effect of direct-acting antiviral treatment on renal function in patients with chronic hepatitis C.
Methods
2
A total of 123 HCV-infected patients receiving DAAs treatment at the Third Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2021 were included in this study. To explore the renal function in patients with chronic hepatitis C treated with direct-acting antivirals， serum creatinine values were collected before， during and after the treatment， which were used to estimate the eGFR by the MDRD equation to assess the changes in renal function.
Results
2
Of
the 123 patients enrolled， 67.5%（
n
=83）were male， and the mean age of participants was （50±11） years old. The mean follow-up period was 24 weeks . Comorbidities included cirrhosis in 26.8%， and diabetes in 10.6%. Meanwhile， 11.4% of the cohort had eGFR
<
60 mL/（min ·1.73 m
2
）， 33.3% of the cohort had eGFR 60 to 90 mL/（min ·1.73 m
2
）， and 55.3% had eGFR≥90 mL/（min ·1.73 m
2
）. No decrease in renal function was seen among all the HCV-infected patients at the end of treatment or the follow-up period after treatment. However， compared with the eGFR at the baseline， eGFR in CKD2 patients in the follow-up period was improved 【（88.65±15.52） mL/（min ·1.73 m
2
）
vs （
78.12 ±7.60） mL/（min ·1.73 m
2
），
P
<
0.001】. And 14.6% （
n
=18） of patients experienced progressive deterioration of renal function. Logistic regression analysis showed that diabetes could predict the deterioration of renal function （OR=4.663，
P
=0.016）.
Conclusions
2
Our study shows renal function is not impair among HCV-infected patients following DAAs treatment， and renal function in CKD2 patients have improvements. However， HCV-infected patients with diabetes mellitus are at a high risk of renal impairment and closely monitoring of renal function is still needed.
关键词
丙型肝炎直接抗病毒药物丙肝治疗肾脏功能
Keywords
hepatitis C virusdirect-acting antiviralsHCV treatmentrenal function
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