Hepatitis B, Chronic Clinical Trial
Official title:
A Cross-sectional Study for Renal Function of Patients With Chronic Hepatitis B in China
1. To acknowledge the prevalence of renal insufficiency and kidney-related diseases in patients with chronic hepatitis B in China through epidemiological surveys in outpatient clinics of about 150 hospitals across the country; 2. To analyze the related factors of renal insufficiency and kidney-related diseases in domestic patients with chronic hepatitis B from the aspects of demographic characteristics, family history, antiviral treatment, nephrotoxic drug use history, etc.
At present, the mainstream antiviral treatment of CHB is still nucleotide analogues. The
increase in the proportion of comorbidities in patients with chronic hepatitis B also
increases the risk of nucleotide analogue contraindications. The antiviral treatment of CHB
patients needs to fully assess the risk of adverse reactions . Taking into account the
current impact of nucleotide analogs on renal function, the AASLD 2018 Chronic Hepatitis B
Guidelines recommends that the dosage of nucleotide analogs should be adjusted according to
renal function and creatinine clearance. A Hong Kong cohort study of patients with chronic
hepatitis B showed that the 5-year chronic kidney disease (CKD) progression rate of patients
receiving entecavir and tenofovir and not receiving treatment reached 40%. A similar study in
the United States also showed that nucleotide analogs reduce the glomerular filtration rate
(estimated glomerular filtration rate, eGFR). Studies on the indicators of early kidney
injury found that the β2 microglobulin and retinol binding protein indicators changed
significantly during the course of patients receiving adefovir dipivoxil, and the baseline β2
microglobulin and retinol binding protein indicators Affect the reduction of eGFR.
Retrospective analysis using recent domestic urban medical insurance data also observed that
the proportion of chronic kidney disease diagnoses in domestic CHB patients has shown a
significant upward trend, which also suggests the necessity of assessing renal function in
domestic CHB patients before using nucleotide analogs. Due to the lack of real-world renal
function screening studies for CHB patients in China, there is a risk of severe
underestimation of the proportion of CHB patients with renal insufficiency estimated based on
medical insurance data. In the real world, the proportion of domestic CHB patients with renal
insufficiency has not been fully clarified. Domestic clinical The treatment guidelines also
did not specifically emphasize the necessity of renal function assessment before receiving
nucleotide analog treatment.
Therefore, the purpose of this study is to understand the prevalence of renal insufficiency
among people receiving hepatitis B antiviral treatment through a national epidemiological
cross-sectional survey, using hospital outpatient clinics as the research site, and to
analyze related factors to improve clinicians Awareness of renal insufficiency in patients
with CHB and better guidance on the safe use of nucleotide analogs in patients with chronic
hepatitis B.
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