CAJ | 학술논문

分析近14个月确诊的6例阿德福韦酯(ADV)相关性肾病患者的临床资料及诊治经过.结果显示,服用ADV 10～20 mg/d,2～3年后出现全身多处骨关节疼痛.均有低磷、低尿酸血症,成骨指标明显升高,1例血肌酐升高,5例有低血钾、肾性糖尿,4例有蛋白尿,影像学检查提示骨质疏松、骨软化、假性骨折.确诊后停用ADV,经补磷及活性D3后,3～6周疼痛缓解,1～2.5个月血尿酸正常,1～2个月肾性糖尿及蛋白尿消失.提示ADV应用超过2年,应注意其引起的肾损害,定期监测肾功能、电解质、尿常规可早期发现肾损害.血尿酸降低是一个较好的诊疗观察指标.
분석근14개월학진적6례아덕복위지(ADV)상관성신병환자적림상자료급진치경과.결과현시,복용ADV 10～20 mg/d,2～3년후출현전신다처골관절동통.균유저린、저뇨산혈증,성골지표명현승고,1례혈기항승고,5례유저혈갑、신성당뇨,4례유단백뇨,영상학검사제시골질소송、골연화、가성골절.학진후정용ADV,경보린급활성D3후,3～6주동통완해,1～2.5개월혈뇨산정상,1～2개월신성당뇨급단백뇨소실.제시ADV응용초과2년,응주의기인기적신손해,정기감측신공능、전해질、뇨상규가조기발현신손해.혈뇨산강저시일개교호적진료관찰지표.
[Summary] An analysis of clinical data was performed in 6 patients diagnosed as adefovir dipivoxil (ADV)-induced nephropathy in recent 14 months.The results showed that all of six patients suffered from pain over multiple joints after taking ADV 10-20 mg/d for 2-3 years,along with hypophosphatemia,hypouricemia,and raised osteogenesis index.One case had increased serum creatinine,5 cases had hypokalemia,renal glycosuria,and4 cases had albuminuria.Imageological examination showed osteoporosis,osteomalacia,and pseudo fracture.After discontinuance of ADV treatment,joint pain was obviously relieved within 3-6 weeks,blood uric acid level returned to normal within 1-2.5 months,and renal glycosuria and albuminuria disappeared by 1-2 months.The results suggest that after taking ADV for more than two years,attention should be paid to the nephropathy induced by ADV and regular monitoring of renal function,blood electrolyte,and urine should be mandatory.Hypouricemia is a reliable index of diagnosis and treatment in this event.