What are the AASLD guidelines for monitoring renal disease in patients with hepatitis B (HBV) (Hep B)?

Updated: Aug 01, 2018
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

With regard to the potential long-term risks of renal and bone complications, the AASLD suggests no preference between entecavir and tenofovir. (Conditional recommendation)

Before initiating, and periodically during, treatment with tenofovir, evaluate patients' renal safety with levels of serum creatinine, phosphorus, urine glucose, and urine protein. If tenofovir is suspected of causing renal dysfunction and/or osteoporosis/osteomalacia, discontinue tenofovir and replace it with another NA, taking into account any previous drug resistance.

Adjust all NA dosing based on patients' renal function and creatinine clearance.


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