Adefovir dipivoxil-induced Fanconi syndrome and its predictive factors: A study of 28 cases

The aim of the present study was to identify monitoring and prevention measures as well as predictive factors for early detection of renal toxicity associated with long-term administration of adefovir dipivoxil in order to avoid progression to Fanconi syndrome. Clinical data of 28 patients with Fanc...

Full description

Saved in:
Bibliographic Details
Published in:Oncology letters 2017-01, Vol.13 (1), p.307-314
Main Authors: Lin, Yong, Pan, Fan, Wang, Yingchao, Chen, Ziqian, Lin, Chun, Yao, Lvfeng, Zhang, Xin, Zhou, Rui, Pan, Chen
Format: Article
Language:English
Subjects:
Adefovir dipivoxil
Age
Antigens
Antiviral drugs
Care and treatment
chronic HBV patient
Complications and side effects
Deoxyribonucleic acid
Development and progression
Diabetes
DNA
Fanconi syndrome
Fractures
Glomerular filtration rate
Health aspects
Hepatitis
Hypertension
kidney damage
Kidney diseases
Laboratories
Liver cirrhosis
Osteoporosis
Pain
Pharmaceuticals
Phosphatase
Standard deviation
Substance abuse treatment
Urine
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The aim of the present study was to identify monitoring and prevention measures as well as predictive factors for early detection of renal toxicity associated with long-term administration of adefovir dipivoxil in order to avoid progression to Fanconi syndrome. Clinical data of 28 patients with Fanconi syndrome caused by long-term administration of adefovir dipivoxil for the treatment of chronic hepatitis B virus (HBV) infection were collected pre-and post-administration for analysis. Patients presented with fatigue, progressive systemic pain in multiple bones and joints, as well as difficulty in walking and pathological fractures in a number of severe cases. Laboratory examinations revealed hypophosphatemia, elevated serum cystatin C (Cys-C), elevated serum creatinine (SCr), reduced glomerular filtration rate (GFR), positive urinary protein, erythrocytes and glucose, as well as osteoporosis. In consequence, adefovir dipivoxil administration was stopped, and patients received concentrated divitamins, sodium phosphate syrup and calcitriol. Symptoms and abnormalities in laboratory examinations were significantly improved in all patients after 2-6 months. Therefore, serum phosphate, SCr, routine urine parameters, Cys-C and GFR should be monitored regularly in chronic HBV patients treated with adefovir dipivoxil. The following factors were identified as predictive of kidney damage and Fanconi syndrome: Age ≥40 years, living in rural areas, previous renal toxicity, estimated GFR (eGFR)
ISSN:1792-1074
1792-1082
DOI:10.3892/ol.2016.5393