Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho

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dc.contributor.authorBygrave, Helenen_ZA
dc.contributor.authorKranzer, Katharinaen_ZA
dc.contributor.authorHilderbrand, Katherineen_ZA
dc.contributor.authorJouquet, Guillaumeen_ZA
dc.contributor.authorGoemaere, Ericen_ZA
dc.contributor.authorVlahakis, Nathalieen_ZA
dc.contributor.authorTriviño, Lauraen_ZA
dc.contributor.authorMakakole, Lipontsoen_ZA
dc.contributor.authorFord, Nathanen_ZA
dc.date.accessioned2015-11-16T04:08:00Z
dc.date.available2015-11-16T04:08:00Z
dc.date.issued2011en_ZA
dc.description.abstractIntroduction 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.en_ZA
dc.identifier.apacitationBygrave, 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. <i>PLoS One</i>, http://hdl.handle.net/11427/14982en_ZA
dc.identifier.chicagocitationBygrave, Helen, Katharina Kranzer, Katherine Hilderbrand, Guillaume Jouquet, Eric Goemaere, Nathalie Vlahakis, Laura Triviño, Lipontso Makakole, and Nathan Ford "Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/14982en_ZA
dc.identifier.citationBygrave, 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.0017609en_ZA
dc.identifier.ris TY - Journal Article AU - Bygrave, Helen AU - Kranzer, Katharina AU - Hilderbrand, Katherine AU - Jouquet, Guillaume AU - Goemaere, Eric AU - Vlahakis, Nathalie AU - Triviño, Laura AU - Makakole, Lipontso AU - Ford, Nathan AB - 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. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0017609 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho TI - Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho UR - http://hdl.handle.net/11427/14982 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14982
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0017609
dc.identifier.vancouvercitationBygrave H, Kranzer K, Hilderbrand K, Jouquet G, Goemaere E, Vlahakis N, et al. Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho. PLoS One. 2011; http://hdl.handle.net/11427/14982.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2011 Bygrave et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherCreatinineen_ZA
dc.subject.otherRenal systemen_ZA
dc.subject.otherToxicityen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherGovernment laboratoriesen_ZA
dc.subject.otherMultivariate analysisen_ZA
dc.subject.otherPrimary careen_ZA
dc.titleRenal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesothoen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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