Abstract
BACKGROUND: Patients with chronic hepatitis B (CHB) require long-term antiviral therapy. The effects of different antiviral drugs on kidney function are unclear. There is a lack of effective markers for monitoring early renal impairment. AIM: To investigate the rate of abnormal renal function index and related potential hazards in patients with CHB. METHODS: Clinical data of patients with CHB with urinary β2-microglobulin (β2-M) detection, including demographic characteristics, hepatitis B virus (HBV) DNA, serum liver function (alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin), serum renal function (urea nitrogen, creatinine), blood lipid index (high density lipoprotein, low density lipoprotein, cholesterol, triglyceride), liver imaging, and other routine tests were retrospectively collected. The normal level of urinary β2-M and estimated glomerular filtration rate (eGFR) is defined as < 0.173 mg/L and ≥ 90 mL/min/1.73 m(2), retrospectively. The proportion of patients with abnormal renal function index and related risk factors were analyzed. RESULTS: A total of 500 patients with CHB were enrolled; these patients were aged 44.7 ± 10.8 years, 67.2% (336/500) were male, 57.2% (286/500) were treated with antiviral drugs, and 52.2% (261/500) had an HBV-related family history. In total, 28.8% (144/500) of patients had fatty liver, 35.0% (175/500) had liver fibrosis, and 13.2% (66/500) had cirrhosis. The proportion of patients with eGFR < 90 mL/min/1.73 m(2) was 43.2% (216/500), and the abnormal rate of urinary β2-M was 56.2% (281/500). There was no significant difference in the abnormal rate of urinary β2-M between the untreated group and the antiviral treated group (54.2% vs 57.7%; P= 0.25). The abnormal rate of β2-M after long-term entecavir treatment (more than 1 year) was 54.6% (89/163). In the treatment group, 56.4% (92/163) of patients with eGFR ≥ 90 mL/min/1.73 m(2) had abnormal urinary β2-M. CONCLUSION: In patients with CHB, a higher proportion had greater urinary β2-M levels than eGFR for renal injury. Male patients should pay more attention to renal function and use antiviral regimens with a renal safety profile.