核苷和核苷酸类药物治疗慢性乙型肝炎过程中肾脏的安全性问题

Renal safety in chronic hepatitis B patients treated with nucleos(t) ide analogues

核苷和核苷酸类药物(NAs)是慢性乙型肝炎(CHB)患者最常用的治疗药物之一,大多数患者需要长期用药。在长期临床实践中,个别NAs在使用过程中出现肾损伤不良反应。因此,从NAs导致肾损伤可能的机制、近期临床研究中各种NAs治疗下患者肾损伤的发生情况以及CHB患者肾损伤的管理等方面对NAs治疗CHB患者过程中的肾脏安全性进行总结,以期为患者选择最合适的治疗药物。

Nucleos（ t） ide analogues（ NAs） are commonly used as the antiviral treatment in patients with chronic hepatitis B（ CHB）. The majority of patients need long term medication. Renal injury has been observed in some patients treated with NAs in clinical practice. Therefore,this article reviews the issues regarding renal safety in CHB patients treated with NAs from the following aspects： the possible mechanisms of renal injury,the incidence of renal injury in patients treated with various NAs in recent clinical studies,and the management of renal injury in CHB patients,in order to select the most appropriate drugs for patients.