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 17 October 2017

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News

Acute kidney injury in chronic Hep C treated with sofosbuvir-based regimens

The frequency of acute kidney injury in patients with chronic hepatitis C virus infection treated with sofosbuvir-based regimens, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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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."

Aliment Pharmacol Ther 2017: 46(1): 46–55
14 June 2017

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