Mechanism of Renal Dysfunction in the Early Phase of Telaprevir Therapy in Combination with Peginterferon-Alfa2b and Ribavirin

Seventeen patients with chronic hepatitis C undergoing telaprevir therapy showed a decrease in the estimated glomerular filtration rate (eGFR), which averaged 77.5 ml/min/1.73 m2 before treatment, by 14.6 ml/min/1.73 m2 on average at day 4. To distinguish between the two main causes of acute renal dysfunction, prerenal mechanism and acute tubular necrosis, we measured the sodium concentration in urine (UNa) and fractional excretion of sodium (FENa). The eGFR decrease showed a significant correlation with UNa and also with FENa. These findings indicate that the prerenal mechanism is responsible for the eGFR decline. As patients with an eGFR drop in the early phase of therapy may have an additional risk of adverse events, renal function should be closely monitored.