Gao GF, Wang XY, Yu J. Rate of abnormal renal function index and related risk factors in patients with chronic hepatitis B. World J Gastroenterol 2025; 31(25): 105207 [DOI: 10.3748/wjg.v31.i25.105207]
Corresponding Author of This Article
Jiao Yu, Chief, MD, PhD, Department of Hepatology, Shanghai Eastern Hepatobiliary Surgery Hospital, Navy Medical University, No. 700 Moyu North Road, Jiading District, Shanghai 200433, China. yujiao7828@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 7, 2025; 31(25): 105207 Published online Jul 7, 2025. doi: 10.3748/wjg.v31.i25.105207
Rate of abnormal renal function index and related risk factors in patients with chronic hepatitis B
Guo-Feng Gao, Xiao-Yu Wang, Jiao Yu
Guo-Feng Gao, Xiao-Yu Wang, Jiao Yu, Department of Hepatology, Shanghai Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai 200433, China
Author contributions: Yu J designed and conducted the study; Gao GF contributed to the analysis and wrote the paper; Wang XY collected the data; All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shanghai Eastern Hepatobiliary Surgery Hospital (Approval No. EHBHKY2022-H006-P001).
Informed consent statement: The study protocol was in accordance with the ethical guidelines of the 1975 Declaration of Helsinki. All patients provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Datasets are available from the corresponding author at yujiao7828@sina.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiao Yu, Chief, MD, PhD, Department of Hepatology, Shanghai Eastern Hepatobiliary Surgery Hospital, Navy Medical University, No. 700 Moyu North Road, Jiading District, Shanghai 200433, China. yujiao7828@sina.com
Received: February 18, 2025 Revised: March 20, 2025 Accepted: May 8, 2025 Published online: July 7, 2025 Processing time: 136 Days and 1.2 Hours
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 m2, 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 m2 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 m2 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.
Core Tip: Oral nucleos(t)ide analogues have been widely used for the treatment of chronic hepatitis B; however, their effects on kidney function remain inconclusive. In this study, no statistically significant differences in the effects of different antiviral drugs on renal function were observed. Urinary β2-microglobulin did not have a significant advantage over estimated glomerular filtration rate as an early warning of renal dysfunction. In addition, being male was an independent risk factor for renal impairment. Thus, men should pay more attention to the changes in renal function indicators when using antiviral drugs, which can provide a clear direction for clinical medication.
