Prospective Study to Assess Progression of Renal Markers after Interruption of Tenofovir due to Nephrotoxicity.

Journal: BioMed research international
PMID:

Abstract

. Prospective studies about the reversibility of tenofovir disoproxil fumarate- (TDF-) related renal impairment remain scarce. . This is an observational prospective study including all patients that presented at our HIV Unit who interrupted TDF owing to nephrotoxicity. We assessed the evolution of renal parameters after discontinuation of this drug. . We included 59 patients, who were followed up for 72 weeks. Most were male (41, 69.5%), median (IQR) age was 53 (44; 58) years, and median time receiving TDF-containing regimens was 55.4 (28; 87.7) months. Most patients were receiving PI-based treatments (67%). At the final visit, most of the subjects showed complete recovery (35, 59.3%) or improvement (13 subjects, 22%). Significant improvements were observed in creatinine levels (from 84.9 [73.8; 97.5] to 78 [69.6; 91] mol/L, = 0.013), estimated glomerular filtration rate (eGFR, CKD EPI equation, from 87.7 [67; 99] to 89.9 [73.6; 99.3] mL/min/1.73 m, = 0.017), and number of patients with eGFR <60 mL/min/1.73 m (from 9 [15.3%] to 1 [1.7%], = 0.031). A trend toward significance was observed in abnormal urine proteinuria/creatinine ratio (from 22 [37%] to 8 [13.6%], = 0.057). . Our results corroborate the high frequency of complete or partial renal recovery in patients receiving TDF-containing regimens who discontinued therapy owing to nephrotoxicity.

Authors

  • Anna Bonjoch
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain.
  • Patricia Echeverría
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain.
  • Núria Perez-Alvarez
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain; Statistics and Operations Research, Technical University of Catalunya, Barcelona, Spain.
  • Jordi Puig
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain.
  • Carla Estany
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain.
  • Bonaventura Clotet
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain; IrsiCaixa Foundation, Barcelona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Barcelona, Spain.
  • Eugènia Negredo
    Lluita Contra la SIDA Foundation, Germans Trias i Pujol University Hospital, Internal Medicine Service, Autonomous University of Barcelona, Barcelona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Barcelona, Spain.