15 September 2009
Kidney function declined slowly in the year after 19 HIV-infected people with pre-existing kidney problems started tenofovir. Although 5 people (26%) had confirmed worsening of kidney disease stage, the clinicians propose that tenofovir may be an option for such patients if they have few antiretroviral options and can be closely monitored.
The study involved 19 members of the HIV Outpatient Study (HOPS) cohort, 6 with a history of renal disease and 13 with current renal disease. They started tenofovir from 2001 through 2005, usually at the licensed dose of 300 mg once daily.
Before these people started tenofovir, their median estimated glomerular filtration rate (GFR) measured 49 mL/min/1.73m(2) and their median CD4 count 322 cells/µL. Median 12-month change in GFR was -0.1 mL/min/1.73m(2) (range -49.8 to +29.5), while median estimated creatinine clearance change from baseline was -0.3 mL/min (range -32.2 to +23.6).
HOPS clinicians confirmed worsening kidney disease stage in 5 of these 19 people.
They conclude that tenofovir “can be considered in patients with preexisting or current renal dysfunction who have limited antiretroviral treatment options, require tenofovir for fully active antiretroviral regimen, and can be closely monitored for incident worsening of renal function.”
Source: Benjamin Young, Kate Buchacz, Anne Moorman, Kathy C. Wood, John T. Brooks. Renal function in patients with preexisting renal disease receiving tenofovir-containing highly active antiretroviral therapy in the HIV Outpatient Study. AIDS Patient Care and STDs. 2009;23:589-592.
For the study abstract
(Downloading the complete article requires a subscription to AIDS Patient Care and STDs or an online payment; the abstract is free.)