Early renal injury indicators can help evaluate renal injury in patients with chronic hepatitis B with long-term nucleos(t)ide therapy

Table 1 Renal function test results of patients with and without adefovir dipivoxil / tenofovir disoproxil fumarate treatment

Treatment group	Increased BUN	Early renal damage	eGFR ≥ 90	eGFR 89-60	eGFR 59-30	Hypophosphatemia
ADV/TDF group, n = 25	3 (12%)	151 (60%)	6 (24%)	16 (64%)	3 (12%)	6 (24%)
Non-ADV/TDF group, n = 44	3 (6.8%)	16 (36.4%)	16 (36.4%)	26 (59.1%)	2 (4.5%)	7 (15.9%)

¹Compared with the non-ADV/TDF treatment group, χ² = 3.600, P = 0.057. ADV: Adefovir dipivoxil; BUN: Serum urea nitrogen; eGFR: Estimated glomerular filtration rate; TDF: Tenofovir disoproxil fumarate.

Table 2 Examination results of patients in different estimated glomerular filtration rate value groups

eGFR value [mL/(min·1.73 m2)]	≥ 90, n = 22	60-89, n = 42	30-59, n = 5
Age in yr	46.8 ± 11.4	58.3 ± 11.9	69.6 ± 16.101
Sex as M/F	18/4	27/15	3/2
Antiviral treatment time in mo	84.0 ± 30.9	111.1 ± 39.2	96.8 ± 38.12
ALT in IU/L	33.36 ± 16.83	22.31 ± 10.35	21.80 ± 10.32
Creatinine in µmol/L	74.71 ± 9.98	86.20 ± 12.83	107.4 ± 12.543
BUN in mmol/L	4.56 ± 1.17	5.38 ± 1.40	6.32 ± 1.494
Cases of increased BUN	0	3 (7.1%)	3 (60%)5
Blood phosphorus in mmol/L	0.94 ± 0.16	1.01 ± 0.15	0.86 ± 0.206
Cases of decreased blood phosphorus	4 (18.2%)	7 (16.7%)	2 (40%)
Cases of early renal injury	8 (36.4%)	20 (47.6%)	3 (60%)
Cases of abnormal urine microalbumin	3 (13.6%)	4 (9.5%)	1 (20%)
Cases of abnormal urine transferrin	1 (4.5%)	5 (11.9%)	0
Cases of abnormal NAG enzyme	5 (22.7%)	8 (19.0%)	1 (20%)
Cases of abnormal α1 microglobulin	5 (22.7%)	11 (26.2%)	3 (60%)
Cases of abnormal urine immunoglobulin	1 (4.5%)	5 (11.9%)	1 (20%)

Comparison among the three groups.

¹Indicates K = 14.979, P = 0.001.

²Indicates K = 7.623, P = 0.022.

³Indicates K = 19.034, P = 0.000.

⁴Indicates comparison between the third group and the first group, t = 2.575, P = 0.012.

⁵Indicates Fisher’s exact test without chi-square value, P = 0.011.

⁶Indicates comparison between the third group and the second group, t = 2.045, P = 0.047. ALT: Alanine aminotransferase; BUN: Serum urea nitrogen; eGFR: Estimated glomerular filtration rate; F: Female; M: Male; NAG: N-acetyl-β-D-glucosidase.

Table 3 Examination results of patients with or without early renal injury

Early renal injury groups	Normal group (n = 38)	Abnormal group (n = 31)
Age in yr	55.8 ± 15.0	55.0 ± 11.9
Sex as M/F	25/13	23/8
Antiviral treatment time in mo	99.3 ± 37.7	104.1 ± 39.4
GGT as IU/L	21.7 ± 11.3	37.2 ± 16.21
DBIL as µmol/L	2.5 ± 1.5	3.5 ± 1.42
Creatinine as µmol/L	81.0 ± 14.0	87.9 ± 14.53
BUN as mmol/L	5.0 ± 1.2	5.4 ± 1.6
Cases of increased serum BUN	2 (5.3%)	3 (9.1%)
eGFR as mL/(min·1.73 m2)	86.5 ± 15.3	80.7 ± 15.5
eGFR ≥ 90, n = 22	14 (36.8%)	8 (25.8%)
eGFR: 70-89, n = 42	18 (47.4%)	13 (41.8%)
eGFR: 60-69, n = 42	4 (10.5%)	7 (22.6%)
eGFR: 30-59, n = 5	2 (5.3%)	3 (9.7%)
UA as µmol/L	314.2 ± 76.2	338.8 ± 88.4
Serum calcium as mmol/L	2.36 ± 0.10	2.35 ± 0.12
Serum phosphorus as mmol/L	0.99 ± 0.16	0.97 ± 0.17
Cases of decreased serum phosphorus	6 (15.8%)	7 (22.6%)
Magnesium as mmol/L	0.95 ± 0.07	0.97 ± 0.07
Urinary creatinine as mmol/L	6.9 (2.5-20.3)	12.4 (5.8-29.5)4
Urine microalbumin as mg/L	4.0 (2-12.8)	11.2 (2-123)5
NAG enzyme as U/L	4.1 (1-12)	10.4 (2-59)6
α1 microglobulin as mg/L	4.9 (4-17.4)	15.5 (4.68-158)7
Urinary immunoglobulin as mg/L	3 (3-4.1)	6.7 (3.14-29.3)8

Comparison between the two groups.

¹Indicates t = −2.508, P = 0.015.

²Indicates t = −2.208, P = 0.031.

³Indicates t = −2.023, P = 0.047.

⁴Indicates U = 306.5, P = 0.001.

⁵Indicates U = 184.5, P = 0.000.

⁶Indicates U = 202.0, P = 0.000.

⁷Indicates U = 91.0, P = 0.000.

⁸Indicates U = 42.5, P = 0.000. BUN: Serum urea nitrogen; DBIL: Direct bilirubin; eGFR: Estimated glomerular filtration rate; F: Female; GGT: Gamma-glutamyl transpeptidase; M: Male; NAG: N-acetyl-β-D-glucosidase; UA: Uric acid.