Hyeki Cho, Yuri Cho, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Kook-Hwan Oh, Kyoungbun Lee, Syifa Mustika, Jung-Hwan Yoon, Yoon Jun Kim
Tenofovir disoproxil fumarate (TDF) is effective against chronic hepatitis B (CHB) infection and its use is increasing rapidly worldwide. However, it has been established that TDF is associated with renal toxicity in human immunodeficiency virus-infected patients, while severe or symptomatic TDF-associated nephrotoxicity has rarely been reported in patients with CHB. Here we present two patients with TDF-associated nephrotoxicity who were being treated for CHB infection. The first patient was found to have clinical manifestations of proximal renal tubular dysfunction and histopathologic evidence of acute tubular necrosis at 5 months after starting TDF treatment. The second patient developed acute kidney injury at 17 days after commencing TDF, and he was found to have membranoproliferative glomerulonephritis with acute tubular injury. The renal function improved in both patients after discontinuing TDF. We discuss the risk factors for TDF-associated renal toxicity and present recommendations for monitoring renal function during TDF therapy.
Gastroenterohepatology Division, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia; Gastroenterohepatology Division, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia; Gastroenterohepatology Division, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia; Gastroenterohepatology Division, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia
