{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:18:06Z","timestamp":1787242686102,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T00:00:00Z","timestamp":1631404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The nephrotoxicity of tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB) patients without chronic kidney disease (CKD) remains controversial. We aimed to evaluate nephrotoxicity of TDF in this population. In this hospital\u2010based cohort study, CHB patients who received either TDF or entecavir (ETV) therapy, and did not have underlying CKD, were retrospectively recruited from January, 2008 to January, 2019. After excluding those with confounding conditions, 257\u00a0TDF\u2010treated patients were matched through propensity scores with 514 ETV\u2010treated patients. Cumulative incidences of, and hazard ratios (HRs) for the CKD guideline\u2010defined renal dysfunction, were analysed. The mean decline in glomerular filtration rate was similar over 60\u00a0months (TDF vs. ETV: 10.1\u00a0ml\/min\/1.73\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    , 95% confidence interval [CI]: 7.4\u201312.7 vs. 8.0\u00a0ml\/min\/1.73\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    , 95% CI: 6.4\u20139.6;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.34). The 5\u2010year cumulative incidence of renal dysfunction was not significantly different (TDF vs. ETV: 10.4%, 95% CI: 5.6\u201318.0 vs. 5.8%, 95% CI: 3.6\u20139.0;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.18). However, in multivariable stratified analysis, TDF was associated with an increased risk of renal dysfunction in the elderly (age \u226560\u00a0years), when compared to ETV (HR 2.86, 95% CI: 1.02\u20138.01;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a0.05). For confirming the effect of TDF amongst the elderly, 61\u00a0TDF\u2010treated patients were further matched with 183 ETV\u2010treated patients, with 5\u2010year cumulative incidence of renal dysfunction being significantly higher in TDF users (TDF vs. ETV: 34.4%, 95% CI: 17.7\u201359.8 vs. 15.5%, 95% CI: 9.4\u201325.1;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a0.05). TDF use was independently related to renal dysfunction (HR 2.71, 95% CI: 1.19\u20136.14;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a0.05). Although TDF is generally safe for CHB patients without CKD, it is best to be avoided in the elderly.\n                  <\/jats:p>","DOI":"10.1111\/jvh.13603","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T17:49:00Z","timestamp":1630432140000},"page":"1579-1586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluating the renal safety of tenofovir disoproxil fumarate in hepatitis B patients without chronic kidney disease"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-7960","authenticated-orcid":false,"given":"Hsin\u2010Ju","family":"Tsai","sequence":"first","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-1339","authenticated-orcid":false,"given":"Ya\u2010Wen","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Shun","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Institute of Biomedical Sciences National Chung Hsing University  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Zin","family":"Chang","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Department of Clinical Laboratory Drug Testing Center Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horng\u2010Rong","family":"Chang","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Division of Nephrology Department of Internal Medicine Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-4315","authenticated-orcid":false,"given":"Teng\u2010Yu","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University  Taichung 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