A longitudinal study of renal function outcomes in a cohort of HIV patients on tenofovir-based antiretroviral therapy in Ashanti region, Ghana

Abstract

OBJECTIVE: Tenofovir disoproxil fumarate (TDF), an integral component of first-line antiretroviral therapy (ART), is associated with nephrotoxicity, including a decline in glomerular filtration rate (GFR). The study describes renal function outcomes and risk factors for TDF-associated renal impairment in a Ghanaian cohort who had no known risk factors for renal impairment. PATIENTS AND METHODS: We included 97 HIV patients who were antiretroviral-naïve at baseline, initiated a TDF-based ART between 2010 and 2018, and had documented baseline renal function tests. We measured follow-up creatinine and urea levels and calculated eGFR using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. We described changes in eGFR from ART initiation using paired t-test. RESULTS: In patients with eGFR >90 ml/min and 24 months. Significant associations with decreased eGFR included longer duration of treatment and older age. CONCLUSIONS: TDF-associated renal impairment was uncommon; however, the risk increases with age and long-term treatment. In this setting, regular monitoring of renal function should be targeted at higher-risk patients.

Keywords

• tenofovir
• gfr
• antiretroviral therapy
• renal function
• hiv