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J Acquir Immune Defic Syndr. 2010 Sep;55(1):78-81. doi: 10.1097/QAI.0b013e3181d05579.

Incomplete reversibility of tenofovir-related renal toxicity in HIV-infected men.

Author information

1
HIV, Immunology, and Infectious Disease Unit and Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.

Abstract

BACKGROUND:

Significant nephrotoxicity develops in 1%-2% of HIV-infected adults receiving tenofovir (TDF). This nephrotoxicity is said to resolve rapidly, but this assessment is based on short follow-up, very few patients and use of serum creatinine, an insensitive measure of renal function.

METHODS:

We determined the reversibility of TDF-related nephrotoxicity in 24 HIV-infected male outpatients who ceased TDF for renal impairment by retrospective assessment of estimated glomerular filtration rate (eGFR) using the Modified Diet in Renal Disease equation.

RESULTS:

Median (interquartile range) eGFR pre-TDF was 74 (61-88) mL.min.1.73 m, fell to 51 (39-61) mL.min.1.73 m at TDF cessation and increased to 58 (48-70) mL.min.1.73 m a median 13 months after TDF cessation (most recent vs pre-TDF eGFR; P = 0.0008). Results were similar with the Cockcroft-Gault equation and after exclusion of patients who had shorter follow-up after TDF cessation. Only 10 (42%) patients reached their pre-TDF eGFR. Greater eGFR improvement was significantly associated with more rapid decline in eGFR on TDF therapy and in those who received TDF with a protease inhibitor, with a trend for shorter duration of TDF therapy.

DISCUSSION:

In this population, TDF-related renal toxicity was not always fully reversible.

Comment in

PMID:
20173649
DOI:
10.1097/QAI.0b013e3181d05579
[Indexed for MEDLINE]

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