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J Am Pharm Assoc (2003) ; 56(3): 280-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27067552

RESUMO

OBJECTIVES: The association of tenofovir (TDF) with nephrotoxicity has been a controversial issue. Few studies are published regarding the reversibility of renal dysfunction once TDF is discontinued. Studies have yet to be conducted in an urban, non-white patient population, making this one of the largest studies observing a non-white cohort. The objective of this study was to determine whether the decline in creatinine clearance (CrCL) associated with TDF use is reversible once TDF is discontinued in a non-white patient population. METHODS: This single-center, retrospective, chart review was performed at an urban outpatient HIV clinic. Patients who had been switched from tenofovir to zidovudine or abacavir because of a decline in renal function were included. The primary endpoint was the percentage of patients who regained full, moderate, mild, or no recovery of CrCl. RESULTS: Sixty-two patients were included. The mean age was 50 years old, 82% were black, and 66% were males with a mean baseline CrCL of 76 ml/min. Mean difference in CrCL from baseline to 12 months post-TDF was shown to be -11.34 ml/min. After a 1-year follow up period, 37.5% of patients had a full recovery of their baseline CrCL. An additional 41% of patients achieved a moderate recovery (80%-99% of baseline CrCL) and 17.9% patients had a mild recovery (50%-79% of baseline CrCL). Two patients required dialysis. The percent of patients with an undetectable HIV RNA while on a TDF-containing regimen was 67.1% compared with 74.6% on alternative ART. CONCLUSION: Renal dysfunction caused by TDF was fully reversible in 37.5% of patients. Improvement to at least 50% of baseline was seen in 96.4% of patients. Viral suppression was not compromised when patient was switched from TDF to an alternative nucleoside reverse transcriptase inhibitor.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/tratamento farmacológico , Tenofovir/efeitos adversos , População Urbana , Injúria Renal Aguda/etnologia , Adulto , Negro ou Afro-Americano , Idoso , Fármacos Anti-HIV/uso terapêutico , Feminino , Taxa de Filtração Glomerular , Infecções por HIV/etiologia , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tenofovir/uso terapêutico
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