Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Treatment of Hepatitis B in chronic kidney disease patients

January's issue of the Alimentary Pharmacology & Therapeutics examines the use of nucleos(t)ide analogues in patients with chronic hepatitis B virus infection and chronic kidney disease.

News image

The treatment of chronic hepatitis B in patients with chronic kidney disease (CKD) is based on nucleoside (lamivudine, telbivudine, entecavir) or nucleotide (adefovir, tenofovir) analogues (NAs), but it may be complex and the information is scarce.

Entecavir and tenofovir represent the currently recommended first-line NAs for NA-naive chronic hepatitis B patients, while tenofovir is the NA of choice for chronic hepatitis B patients with resistance to nucleosides.

Dr Papatheodoridis and colleagues from Greece reviewed the efficacy and safety of NAs in adult chronic hepatitis B patients with chronic kidney disease and to provide reasonable recommendations for their optimal management.

The team performed a literature search in PubMed/Medline and manual search of relevant articles, reviews and book chapters.

Psychiatric drug dispensings were more common among female IBD patients
Alimentary Pharmacology & Therapeutics

NAs are cleared by kidneys and their dosage should be adjusted in patients with creatinine clearance <50 mL/min.

The team report concerns about nephrotoxic potential of the nucleotides, particularly adefovir, while improvements of creatinine clearance have been reported under telbivudine.

The researchers noted that most existing data in chronic hepatitis B patients with CKD are for lamivudine and, less frequently, for other NAs, mostly entecavir.

Besides chronic hepatitis B, NA should be used in case of immunosuppressive therapy in any HBsAg-positive patient with CKD including renal transplant (RT) recipients, and in anti-HBs-positive recipients of kidney grafts from HBsAg-positive donors.

Dr Papatheodoridis' team comments, "Chronic hepatitis B patients with chronic kidney disease receiving nucleoside analogues should be followed carefully for treatment efficacy and renal safety."

"Despite the absence of strong data, entecavir and telbivudine seem to be the preferred options for nucleoside analogue-naive chronic hepatitis B patients with chronic kidney disease, depending on viraemia and severity of renal dysfunction."

"More studies are certainly needed in this setting."

Aliment Pharmacol Ther 2014: 39(1): 35-46
11 December 2013

Go to top of page Email this page Email this page to a colleague

 02 October 2014

Advanced search
 02 October 2014 
Predictive model of Hep C disease progression
 02 October 2014 
Person-to-person transmission of norovirus
 02 October 2014 
IPAA with or without preoperative radiation
 01 October 2014 
Prevention of postop Crohn's
 01 October 2014 
Cecal intubation time during colonoscopy
 01 October 2014 
Anti-TNFa therapies during pregnancy in IBD
 30 September 2014 
Autoimmune hepatitis
 30 September 2014 
Medication use in patients with chronic Hep C
 30 September 2014 
Gastric cancer according to H pylori infection status
 29 September 2014 
Drug exposure and microscopic colitis
 29 September 2014 
Peptic ulcer bleeding after PPI treatment
 29 September 2014 
Intestinal tuberculosis vs Crohn's disease
 26 September 2014 
5-aminosalicylates for the treatment of Crohn's
 26 September 2014 
Response to infliximab in paediatric perianal Crohn's
 26 September 2014 
Ondansetron for IBS with diarrhea
 25 September 2014 
Colorectal neoplasia among family members of patients with colorectal cancer
 25 September 2014 
Medical treatment and surgery rates in IBD
 25 September 2014 
Liver transplants for liver cancer
 24 September 2014 
Health services burden of IBD
 24 September 2014 
PPIs after antireflux surgery
 24 September 2014 
Antidepressants in chronic liver disease
 23 September 2014 
Upper GI bleeding with drug combinations
 23 September 2014 
Recurrence of Barrett's neoplasia after resection
 23 September 2014 
Abnormal prion protein in appendixes
 22 September 2014 
Anorectal function after low anterior resection
 22 September 2014 

Anorectal stricture in Crohn's

 22 September 2014 
Malignancies in celiac disease
 19 September 2014 
Adhesions in abdominal and pelvic surgery
 19 September 2014 
Repeat colonoscopy among US Medicare
 19 September 2014 
Progression to liver cancer in HCV-infected Veterans
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 12 September 2014 
Management of complex colon polyps
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us