Tenofovir-Associated Kidney Toxicity in HIV-Infected Patients: A Review of the Evidence


Hall, AM; Hendry, BM; Nitsch, D; Connolly, JO; (2011) Tenofovir-Associated Kidney Toxicity in HIV-Infected Patients: A Review of the Evidence. American journal of kidney diseases, 57 (5). pp. 773-780. ISSN 0272-6386 DOI: https://doi.org/10.1053/j.ajkd.2011.01.022

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Abstract

Tenofovir (TDF) is an effective and widely used treatment for both human immunodeficiency virus (HIV) and hepatitis B virus infection. Although studies suggest that TDF has a low overall toxicity profile and only a modest effect on estimated glomerular filtration rate, numerous case reports have since appeared in the literature describing TDF-associated renal tubular dysfunction, and this is now a significant source of HIV-related referrals to nephrologists. The main target of toxicity appears to be the proximal tubule, and in severe cases, patients can develop renal Fanconi syndrome. We review findings from recent studies in this area performed by ourselves and others and discuss our direct experience as practicing nephrologists. In particular, we discuss: (1) the nature and extent of TDF-associated kidney toxicity in the HIV-infected population, (2) potential underlying mechanisms of toxicity in the proximal tubule, (3) risk factors for developing tubular dysfunction, and (4) suggested strategies to monitor patients on TDF therapy. Am J Kidney Dis. 57(5): 773-780. (C) 2011 by the National Kidney Foundation, Inc.

Item Type: Article
Keywords: Kidney, Fanconi syndrome, Tenofovir, toxicity, REVERSE-TRANSCRIPTASE INHIBITORS, ACQUIRED-IMMUNODEFICIENCY-SYNDROME, NEPHROGENIC DIABETES-INSIPIDUS, ACTIVE ANTIRETROVIRAL THERAPY, FANCONI-SYNDROME, DISOPROXIL FUMARATE, RENAL-FAILURE, MITOCHONDRIAL, TOXICITY, TUBULAR DYSFUNCTION, ANTIVIRAL DRUGS
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 21435764
Web of Science ID: 289513600021
URI: http://researchonline.lshtm.ac.uk/id/eprint/836

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