Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho
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2011
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PLoS One
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Public Library of Science
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University of Cape Town
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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.
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Bygrave, H., Kranzer, K., Hilderbrand, K., Jouquet, G., Goemaere, E., Vlahakis, N., ... & Ford, N. (2011). Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho. PLoS One, 6(3), e17609. doi:10.1371/journal.pone.0017609