Clinical consequence of hypophosphatemia during antiviral therapy for chronic hepatitis B

• Published in: Kidney research and clinical practice Vol. 44; no. 1; pp. 123 - 131
• Main Authors: Park, Mee Yeon, Jeon, Hojin, Park, Kyungho, Jeon, Junseok, Park, Minsu, Chi, Sang Ah, Kim, Kyunga, Sinn, Dong Hyun, Lee, Jung Eun, Gwak, Geum-Youn, Huh, Wooseong, Kim, Yoon-Goo, Jang, Hye Ryoun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Nephrology 01.01.2025; 대한신장학회
• Subjects: Original; 내과학; Phosphates; Antiviral agents; Infections; Chronic hepatitis B; Glomerular filtration rate
• ISSN: 2211-9132; 2211-9140
• DOI: 10.23876/j.krcp.22.197

Antiviral therapy is an essential treatment for chronic hepatitis B (CHB) infection. Although hypophosphatemia is an important adverse effect of antiviral agents, its clinical significance remains unclear. We investigated the incidence and clinical consequences of hypophosphatemia in a large cohort of CHB patients. This retrospective cohort study included CHB patients who started antiviral therapy between 2005 and 2015 and continued it for at least 1 year. Patients with decompensated liver cirrhosis, diabetes mellitus, hypertension, concomitant diuretic administration, and end-stage renal disease were excluded. The primary outcome was a change in renal function. Secondary outcomes included the incidence of infection and changes in serum potassium, uric acid, and total carbon dioxide (tCO2). Among the 4,335 patients, hypophosphatemia developed in 75 (1.7%). During the median 2-year follow-up period, patients with hypophosphatemia showed a lower estimated glomerular filtration rate than those in the control group. The incidence of infection and changes in serum potassium, uric acid, and tCO2 were similar between groups. Hypophosphatemia was associated with a renal function decline in patients with CHB receiving antiviral therapy.