Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho.
| Autor: | Bygrave H; Médecins Sans Frontières, Morija, Lesotho. helen.bygrave@joburg.msf.org, Kranzer K, Hilderbrand K, Jouquet G, Goemaere E, Vlahakis N, Triviño L, Makakole L, Ford N |
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| Jazyk: | angličtina |
| Zdroj: | PloS one [PLoS One] 2011 Mar 02; Vol. 6 (3), pp. e17609. Date of Electronic Publication: 2011 Mar 02. |
| DOI: | 10.1371/journal.pone.0017609 |
| Abstrakt: | Introduction: Current guidelines contraindicate TDF use when creatinine clearance (CrCl) falls below 50 ml/min. We report prevalence of abnormal renal function at baseline and factors associated with abnormal renal function from a community cohort in Lesotho. Methods: We calculated changes in CrCl from baseline for patients initiated on TDF at 6 and 12 months and the proportion of patients initiated on TDF who developed renal impairment. Screening algorithms were developed using risk factors determined by multivariate analysis. Results: Among 933 adults for whom baseline creatinine was available, 176 (18.9%) presented with a baseline CrCl <50 ml/min. Renal function improved during follow-up. 19 patients who developed renal toxicity during follow up remained on TDF; renal function improved (CrCl≥50 ml/min) in all but 3 of these patients. Among 15 patients with a baseline CrCl <50 ml/min were started in error, none developed severe renal impairment. Conclusion: In this setting TDF-associated renal toxicity is rare and mainly transient. Further studies to assess TDF safety at lower CrCl thresholds are warranted. |
| Databáze: | MEDLINE |
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