Neutrophil gelatinase-associated lipocalin partly reflects the dynamic changes of renal function among chronic hepatitis C patients receiving direct-acting antivirals

PLoS One. 2021 Aug 26;16(8):e0256505. doi: 10.1371/journal.pone.0256505. eCollection 2021.

Abstract

Background: Changes in renal function in chronic hepatitis C (CHC) patients receiving direct-acting antivirals (DAAs) are controversial. The evolution of neutrophil gelatinase-associated lipocalin (NGAL) in these patients remains unclear.

Methods: A total of 232 CHC patients receiving DAA at Dalin Tzu Chi Hospital from May 2016 to February 2019, were enrolled in this retrospective study. Grade 2/3 renal function deterioration, defined as a decrease in eGFR between 10% and 50% from baseline (BL) to 12 weeks after the end of treatment (P12), was investigated for its association with BL characteristics. The changes in renal function and NGAL levels were also analyzed at the SOF-base or nonSOF-base DAA.

Results: Sixty-two patients (26.7%) had grade 2/3 renal function deterioration at P12 after DAA therapy. Univariate analysis showed that it was associated with age (P = 0.038). Multivariate analysis indicated that age (OR = 1.033, 95% CI: 1.004-1.064, P = 0.027), sex (male; OR = 2.039, 95% CI: 1.093-3.804, P = 0.025), ACEI/ARB use (OR = 2.493, 95% CI: 1.016-6.119, P = 0.046), and BL NGAL (OR = 1.033, 95% CI: 1.001-1.067, P = 0.046) positively correlated with grade 2/3 renal function deterioration. Furthermore, eGFR was decreased (P = 0.009) and NGAL was increased (P = 0.004) from BL to P12 in CHC patients receiving SOF-based DAA.

Conclusions: Of the CHC patients receiving DAA therapy, 26.7% had grade 2/3 renal function deterioration at P12, and it was associated with older age, gender being male, ACEI/ARB use, and higher BL NGAL levels. In addition, NGAL might be a biomarker of nephrotoxicity at P12 in patients receiving SOF-based DAA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Female
  • Glomerular Filtration Rate
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / physiopathology*
  • Humans
  • Kidney / physiopathology*
  • Lipocalin-2 / metabolism*
  • Male
  • Middle Aged
  • Sofosbuvir / pharmacology
  • Sofosbuvir / therapeutic use

Substances

  • Antiviral Agents
  • LCN2 protein, human
  • Lipocalin-2
  • Sofosbuvir

Grants and funding

This study was funded by the Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation through grant numbers DTCRD108-I-10 and the Buddhist Tzui Chi Medical Foundation through grant number TCMF-MP 109-01-01. The sponsors played no role in the study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.