Efficacy and safety of entecavir for hepatitis B virus-associated glomerulonephritis with renal insufficiency.

BACKGROUND: HBV-GN is one of the most common secondary kidney diseases in China. Entecavir is a first-line antiviral therapy in patients with HBV-GN.

OBJECTIVE: This retrospective study explored whether entecavir is effective and safe for the treatment of HBV-GN with renal insufficiency.

METHODS: We screened patients diagnosed with HBV-GN in The Affiliated Hospital of Qingdao University who had elevated serum creatinine levels. Group 1 (30 patients) was given entecavir as antiviral treatment. Group 2 (28 patients) was treated with ARBs. Changes in renal function and the possible influencing factors were observed, with a mean follow-up duration of 36 months.

RESULTS: At the end of follow-up, the elevation in the serum creatinine level and reduction in the eGFR were greater in group 1 than in group 2. The overall renal survival rate, using eGFR < 15 ml/min as the primary renal end point, was 96.7% in group 1 and 67.9% in group 2. Urine protein excretion was decreased in both groups. Treatment with entecavir and the remission of proteinuria were protective factors against renal function impairment, while a lower baseline eGFR was a risk factor for progression to ESRD.

CONCLUSIONS: Entecavir slows the progression of renal function impairment in HBV-GN and exerts a significant renal protective effect.