Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong.
J Clin Pharm Ther. 2012 Apr;37(2):128-31. doi: 10.1111/j.1365-2710.2011.01278.x. Epub 2011 Jun 30.
Adefovir dipivoxil (ADV) is an oral bioavailable prodrug of adefovir that possesses potent in vitro activity against hepadnaviruses, retroviruses and herpes viruses. ADV is excreted unchanged in the urine through glomerular filtration and tubular secretion and is known to be nephrotoxic at doses of 60mg daily and above. Thus, the long-term safety of ADV, particularly nephrotoxicity, is a major concern. Our objective is to comment on the nephrotoxcicity of low-dose (10mg daily) ADV through a case report.
The clinical features of nephrotoxicity because of ADV are described. A case report of acquired Fanconi's syndrome in a chronic hepatitis B patient treated with ADV 10mg daily is used to illustrate several key aspects.
Adefovir dipivoxil can be nephrotoxic at conventional dosage and therefore, patients treated with long-term ADV should have regular monitoring of renal function, and calcium and phosphate levels.
阿德福韦酯（ADV）是阿德福韦的口服生物可利用前药，对肝病毒、逆转录病毒和疱疹病毒具有很强的体外活性。ADV 通过肾小球滤过和管状分泌以不变的形式排泄在尿液中，已知在每天 60mg 及以上剂量时具有肾毒性。因此，ADV 的长期安全性，特别是肾毒性，是一个主要关注点。我们的目的是通过病例报告来评论低剂量（每天 10mg）ADV 的肾毒性。
描述了 ADV 引起的肾毒性的临床特征。使用慢性乙型肝炎患者接受 ADV 每天 10mg 治疗后发生获得性 Fanconi 综合征的病例报告来说明几个关键方面。
阿德福韦酯在常规剂量时也可能具有肾毒性，因此，接受长期 ADV 治疗的患者应定期监测肾功能以及钙和磷水平。
