The frequency of acute kidney injury in patients with chronic hepatitis C virus infection treated with sofosbuvir‐based regimens. Issue 1 (3rd May 2017) - Maan, R.
Summary: Background: Guidelines recommend withholding sofosbuvir (SOF) in patients with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min. Aim: To assess the risk of acute kidney injury (AKI) in patients with no renal contraindications for SOF‐based treatment. Methods: This multicenter retrospective observational study included all consecutive patients that were treated with SOF‐based or telaprevir/boceprevir (TVR/BOC)‐based regimens at two tertiary university centers in North America. AKI was defined as an increase of ≥0.3 mg/dL (≥26.5 μmol/L) in serum creatinine level. Multivariable logistic regression analysis was used to identify risk factors for the occurrence of AKI. Results: In total, 426 patients were included and treated with a SOF‐based regimen (n=233, 54.7%) or TVR/BOC‐based regimen (n=193, 45.3%). Among patients treated with a TVR/BOC‐based regimen 34 (18%) of 193 patients experienced AKI compared to 26 (11%) of 233 patients treated with SOF‐based regimens ( P =.056). Multivariable logistic regression analysis showed that the presence of ascites (OR: 4.44, 95%CI: 1.46‐13.54, P =.009) and the use of NSAIDs (OR: 4.47, 95%CI: 1.32‐15.19, P =.016) were associated with a risk of AKI during SOF‐based antiviral therapy. Creatinine levels returned to normal at end of follow‐up in 23 (88%) of the 26 patients who experienced AKI with a SOF‐based regimen and had a creatinine level available during follow‐up. Conclusions: Although the risk for AKI was lower than for patients treated with TVR/BOC‐based regimens, AKI was seen during 11% of SOF‐based regimens and was mostly reversible. Patients with ascites and patients using NSAIDs have an increased risk for AKI during SOF‐based antiviral therapy. Abstract : Linked Content This article is linked to Maan et al, and Hussaini and Yoshida papers. To view these articles visithttps://doi.org/10.1111/apt.14187 andhttps://doi.org/10.1111/apt.14161 .