Tenofovir-induced Fanconi syndrome and osteomalacia in two HIV-infected patients: Role of intracellular tenofovir diphosphate levels and review of the literature

Abstract

We present 2 human immunodeficiency virus-infected patients with tenofovir disoproxil fumarate-induced Fanconi syndrome, leading to osteomalacia. Intracellular tenofovir diphosphate levels were measured in 1 patient and were found to be very high, with plasma tenofovir levels just slightly elevated. Fibroblast growth factor-23, a phosphaturic hormone, was decreased in both patients and is therefore unlikely to have a pathophysiological role in this pathology. The different potential factors contributing to the development of tenofovir-related kidney proximal tubular dysfunction are discussed and the data presented may help to further elucidate its pathogenesis.

Keywords::

• renal insufficiency
• Tenofovir
• HIV
• Fanconi syndrome
• osteomalacia
• FGF23

Declaration of interest: No funding was received. No conflicts of interest.

Notice of Correction

The Early Online version of this article published online 12^th May 2011 contained errors in the numbering of the references: references 10 and 11 should have been switched.

The errors has been corrected in the current version.