Guidelines recommend withholding sofosbuvir in patients with an estimated glomerular filtration rate of less than 30 mL/min.
Dr Andres Duarte-Rojo and colleagues from Arizona, USA assessed the risk of acute kidney injury in patients with no renal contraindications for sofosbuvir-based treatment.
The team performed a multicenter retrospective observational study included all consecutive patients that were treated with sofosbuvir-based regimens at 2 tertiary university centers in North America.
Acute kidney injury was defined as an increase of 0.3 mg/dL or more in serum creatinine level.
|The scope of the position statement included evidence that serrated lesions have premalignant potential|
|Alimentary Pharmacology & Therapeutics|
In total, 426 patients were included and treated with a sofosbuvir-based regimen or telaprevir/boceprevir-based regimen.
The team found that among patients treated with a telaprevir/boceprevir-based regimen, 18% experienced acute kidney injury compared to 11% of patients treated with sofosbuvir-based regimens.
The researchers showed that the presence of ascites, and the use of NSAIDs were associated with a risk of acute kidney injury during sofosbuvir-based antiviral therapy.
Creatinine levels returned to normal at end of follow-up in 88% of patients who experienced acute kidney injury with a sofosbuvir-based regimen, and had a creatinine level available during follow-up.
Dr Duarte-Rojo's team comments, "Although the risk for acute kidney injury was lower than for patients treated with telaprevir/boceprevir-based regimens, acute kidney injury was seen during 11% of sofosbuvir-based regimens and was mostly reversible."
"Patients with ascites and patients using NSAIDs have an increased risk for acute kidney injury during sofosbuvir-based antiviral therapy."