Tenofovir-induced nephrotoxicity: A retrospective cohort study
- Author:
Hui Moon Koh
;
Suresh Kumar
- Publication Type:Journal Article
- Keywords:
Tenofovir;
nephrotoxicity;
renal dysfunction;
risk factors;
incidence
- From:
The Medical Journal of Malaysia
2016;71(6):308-312
- CountryMalaysia
- Language:English
-
Abstract:
Background: Tenofovir (TDF) has been associated with renal
function deterioration, but local data regarding the incidence
and risk factors for this adverse event were lacking.
Objectives: To determine the incidence of nephrotoxicity in
HIV-infected patients on tenofovir-based regimens and to
evaluate risk factors involved in tenofovir-associated renal
function decline.
Methods: This is a single-centre retrospective cohort study
of 440 HIV-infected adults who were started on tenofovirbased
antiretroviral regimens. Data were extracted from
electronic medical and pharmacy records.
Results: A decline in eGFR of 25% or more was seen in 67
patients (15.2%) with an estimated incidence rate of 12 per
100 person-years. Among all 440 subjects, 22 discontinued
TDF-based therapy due to renal complication. From
multivariate analysis, the odds of developing >25% decrease
in eGFR with tenofovir-containing regimen was three times
higher for patients with baseline moderate renal impairment
(HR 3.19; 95% CI, 1.43-7.12; p=0.005) and 14 times higher for
patients with baseline severe renal impairment (HR 14.2;
95% CI, 11.20-170.7; p=0.036) as compared to those without
pre-existing renal insufficiency. Age above 50 years and CD4
cell count of less than 50 were significantly associated with
>25% decrement in eGFR.
Conclusion: The incidence rate of tenofovir-related renal
dysfunction was found to be 12 per 100 person-years. Preexisting
renal impairment, age 50 and above, and CD4 cell
count below 50 as were predictors for renal function decline.
Given that the use of tenofovir is escalating in Malaysia,
increased awareness about this adverse event is essential.
- Full text:P020170208400555073410.pdf
