Serious Renal Impairment Occurs Rarely with Use of Tenofovir DF

Abstract

Purpose: The purpose of this study was to evaluate the short-term effects (up to 6 months) of tenofovir disoproxil fumarate (DF) use on renal function in patients being treated for HIV-1 infection. Method: The charts of 447 HIV-1-infected patients who received at least three months of tenofovir DF treatment were reviewed. Data collected included demographics, concurrent antiretrovirals, other concurrent medications, CD4 counts and HIV-1 viral loads, and serum creatinine values while on tenofovir DF. Data collection was truncated at 6 months. Results: Baseline serum creatinine (SCr) was 1.0 mg/dL, with a calculated creatinine clearance (CL_Cr) of 95.2 mL/min (using the Cockroft-Gault equation). There was no significant change in SCr or CL_Cr at 12 weeks (1.1 mg/dL and 92.7 mL/min, respectively) or 24 weeks (1.1 mg/dL and 92.9 mL/min, respectively). All three patients with grade 2 increases in SCr had other medical reasons for an increased SCr (one patient each had indinavir-associated nephrolithiasis, lactic acidosis, and pancreatitis). No patients experienced any complications from these increases in SCr. Conclusion: Increases in SCr and CL_Cr within the first 6 months of tenofovir DF therapy were rare. Although no clinical nephrotoxicity was observed, continued observation of renal function is warranted in patients predisposed to renal impairment.

Keywords:

• pharmacology
• renal
• tenofovir