  The best way to treat chronic hepatitis B is with pegylated interferon alone
or with oral antiviral drugs. There is limited research comparing the renal
safety of entecavir and tenofovir when used with pegylated interferon. This
study will compare changes in renal function in chronic hepatitis B patients
treated with pegylated interferon and either entecavir or tenofovir. The study
included a cohort of 836 patients with chronic hepatitis B (CHB) who received
treatment with pegylated interferon (IFN) either alone or in combination with
entecavir (ETV) and tenofovir (TDF) between the years 2018 and 2021. Of these
patients, 713 were included in a matched analysis comparing outcomes between
those who were cured and those who were uncured, while 123 patients received
IFN alone as a control group for comparison with the ETV and TDF treatment
groups. The primary outcome measured was the change in renal function,
specifically estimated glomerular filtration rate (eGFR), cystatin C (CysC),
and inorganic phosphorus (IPHOS). Patients were categorized into stage 1 or
stage 2 based on a baseline eGFR of less than 90 ml/min/m^2 Results: 125 CHB
patients were matched 1:1 in both the combined treatment and cured groups.
Baseline eGFR, CysC, and IPHOS levels were similar between the groups. Renal
function in stage 1 and stage 2 groups showed a decreasing trend at 48 weeks
after an initial increase.Correlation analysis showed significant relationships
between changes in ALT and eGFR values at 12 weeks in both non-cured and cured
groups. Conclusions: Over the 48-week duration of combined treatment in
patients with chronic hepatitis B (CHB), it was found that both Tenofovir
Disoproxil Fumarate (TDF) and Entecavir (ETV) did not lead to an increase in
renal injury.
