关键词: 阿德福韦酯, 肾损害, Fanconi综合征, 低磷性骨软化症, 不良反应

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To analyze the clinical characteristics and treatment approaches of hypophosphatemic osteomalacia（HO） induced by adefovir dipivoxil（ADV）.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective analysis was performed according to the clinical data of twelve cases of ADVinduced HO who were admitted in Jinling Hospital, from September 1st, 2010 to October 1st, 2017. The clinical features and outcome were summarized and compared with 6 cases ADVcorrelated Fanconi syndrome without HO.
Ｒｅｓｕｌｔｓ：12 patients were the mean age of 481±115 years, all of them suffered from pain over multiple joints after taking ADV for an average of 47 years, combined the increase of hypophosphatemia and alkaline phosphatase, some of them were accompanied with hypouricemia（75%）and hypokalemia（50%）. Main renal damage was proximal tubule dysfunction, with the performance of Fanconi syndromes (glycosuria, aminoaciduria or urinary phosphorus excretion increased), together with less to moderate proteinuria, mildly elevated serum creatinine. Renal biopsy mainly prompted tubulointerstitial lesions; imaging showed osteoporosis. Compared with 6 cases of ADVcorrelated Fanconi syndromes who didnt combine HO, 12 patients suffered HO had abnormal imaging manifestations and obviously higher AKP, other indicators were not statistically significant. After withdrawal of ADV, the bones pain was distinctly relieved, the level of blood phosphorus was increased, and the tubule function were improved.
Ｃｏｎｃｌｕｓｉｏｎ：
Longterm taking ADV could lead to HO, clinical manifestations are bones pain and Fanconi syndromes. We should pay attention to AKP and imaging examination.

Key words: adefovir dipivoxil, renal damage, fanconi syndrome, hypophosphatemic osteomalacia, adverse reaction