Tenofovir Linked with Acute Kidney Injury in HIV-Infected Patients

The research team at Hospital das Clínicas de Pernambuco in Brazil.

Tenofovir (TDF), a widely-prescribed antiretroviral therapy for patients infected with HIV, is associated with acute kidney injury (AKI), according to a new study that will be presented at ASN Kidney Week 2015, held Nov. 3-8, 2015 in San Diego. AKI is a costly, yet preventable, health burden linked to nephrotoxic medications, such as medical imaging dyes and anti-inflammatories, and a common postoperative complication.

Researchers led by Teg Marcos Veiga, MD, of Hospital das Clínicas de Pernambuco in Brazil, retrospectively evaluated clinical characteristics and outcomes of AKI associated with the use of TDF in HIV inpatients between March 2011 and February 2015. Among 72 patients, nephrotoxic AKI occurred in 36 cases, 19 of which (26 percent) were associated with TDF. Of these 19, TDF nephrotoxicity was present in 7 patients without other associated factors.

Even though the drug was withdrawn in all cases, 37 percent of the patients needed hemodialysis and 58 percent did not completely recover their kidney function. Four of the patients died due to complications from sepsis, and 1 died from hemorrhagic shock. No patients became dialysis dependent.

“Since Tenofovir is a first-line therapy for HIV, infectious disease specialists and clinicians should be aware of the risk of nephrotoxicity related to its use, especially in the context of other drugs and factors that could increase AKI,” said Veiga.

Study: “Tenofovir Nephrotoxicity is an Important Cause of Acute Kidney Injury in HIV Infected Inpatients” (Abstract FR-PO481)

Source: American Society of Nephrology (ASN)