PLoS ONE (Jan 2016)

Risk of Chronic Kidney Disease among Patients Developing Mild Renal Impairment during Tenofovir-Containing Antiretroviral Treatment.

  • Giuseppe Lapadula,
  • Davide Paolo Bernasconi,
  • Salvatore Casari,
  • Franco Maggiolo,
  • Roberto Cauda,
  • Massimo Di Pietro,
  • Nicoletta Ladisa,
  • Laura Sighinolfi,
  • Sarah Dal Zoppo,
  • Francesca Sabbatini,
  • Alessandro Soria,
  • Chiara Pezzoli,
  • Annalisa Mondi,
  • Silvia Costarelli,
  • Maria Grazia Valsecchi,
  • Carlo Torti,
  • Andrea Gori,
  • Italian MASTER cohort

DOI
https://doi.org/10.1371/journal.pone.0162320
Journal volume & issue
Vol. 11, no. 9
p. e0162320

Abstract

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BACKGROUND:Tenofovir (TDF) can cause kidney injury through tubular dysfunction, with or without drop of estimated glomerular filtration rate (eGFR). Whether mild eGFR reductions during treatment should be considered a reason for prompt TDF discontinuation, however, remains unclear. METHODS:Patients with normal pre-TDF eGFR levels, who had developed mild renal impairment (i.e., two consecutive eGFR results between 89-60 ml/min) on TDF, were observed until onset of chronic kidney disease (CKD), defined as two eGFR6 months despite mild renal impairment, current TDF use was not associated with a significantly higher rate of CKD. Other significant predictors of CKD were older age, intravenous drug use, diabetes, hypertension, lower pre-TDF eGFR, higher eGFR drop since TDF introduction and longer exposure to TDF. CONCLUSIONS:Prompt discontinuation of TDF among patients developing mild renal impairment may prevent further progression of renal damage.