Endemic Medicine and Hepatology Department, Faculty of Medicine.
Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e992-e998. doi: 10.1097/MEG.0000000000001977.
Urinary β2-microglobulin (β2-M) is a marker for renal tubular dysfunction. The current study aimed to assess urinary β2-M as a reliable marker for early prediction of tenofovir disoproxil fumarate (TDF)-related nephrotoxicity among hepatitis B virus (HBV) patients.
Forty-two HBV patients who were a candidate for TDF therapy or have recently started it (for less than 6 months) were enrolled and subjected to demographic, clinical, laboratory assessment, abdominal ultrasound and transient elastography. The glomerular filtration rate (GFR) was estimated using the Cockcroft-Gault equation. Also, urinary β2-M was measured by the ELISA method within 6 months after the introduction of TDF treatment and 6 months later.
Mean age was 41.8 (9.55) years, 27 were males and 59.5% of patients have elevated urinary β2-M after 6 months follow-up of TDF therapy. Urinary β2-M was 0.07 ± 0.07 μg/ml at baseline and insignificantly increased up to 0.09 ± 0.08 μg/ml after 6 months follow-up. Despite the insignificant increase in serum creatinine from 0.85 ± 0.23 mg/dl at baseline to 0.9 ± 0.21 mg/dl after 6 months and the insignificant decrease in eGFR from 126.2 ± 39.72 ml/min at baseline and 117.64 ± 42.23 ml/min at 6 months follow-up. No correlation was found between the changes in urinary β2-M and the changes in other renal function indices at baseline and 6 months follow-up.
Short-term TDF therapy is associated with nonsignificant changes either in eGFR or urinary β2-M; these changes are not clinically relevant that indicates disease progression. Therefore, the suitability of urinary β2-M as a screening tool for tenofovir induced tubular dysfunction should be further.
β2-微球蛋白（β2-M）是肾小管功能障碍的标志物。本研究旨在评估β2-M 作为替诺福韦酯（TDF）相关肾毒性的早期预测标志物的可靠性。
纳入 42 名候选 TDF 治疗或近期开始（<6 个月）的乙型肝炎病毒（HBV）患者，进行人口统计学、临床、实验室评估、腹部超声和瞬时弹性成像。肾小球滤过率（GFR）采用 Cockcroft-Gault 方程估算。此外，在 TDF 治疗后 6 个月内和 6 个月后，通过 ELISA 法测量尿β2-M。
平均年龄为 41.8（9.55）岁，27 名男性，59.5%的患者在 TDF 治疗 6 个月后尿β2-M 升高。基线时尿β2-M 为 0.07±0.07μg/ml，6 个月后无显著增加至 0.09±0.08μg/ml。尽管血清肌酐从基线的 0.85±0.23mg/dl 无显著增加至 6 个月时的 0.9±0.21mg/dl，eGFR 从基线时的 126.2±39.72ml/min 显著下降至 6 个月时的 117.64±42.23ml/min，但无相关性。在基线和 6 个月随访时，尿β2-M 的变化与其他肾功能指标的变化之间均无相关性。
短期 TDF 治疗与 eGFR 或尿β2-M 的无显著变化相关；这些变化在临床上没有相关性，表明疾病没有进展。因此，尿β2-M 作为替诺福韦诱导的肾小管功能障碍筛查工具的适用性尚需进一步研究。
