Renal Injury and Dysfunction among HIV Positive Patients Receiving Tenofovir Based Anti-Retroviral Therapy
DOI:
https://doi.org/10.55374/jseamed.v1i1.34Keywords:
Tenofovir, Tubulopathy, Acute kidney injuryAbstract
The rate of renal disease among patients with HIV has decreased significantly since the introduction of highly active antiretroviral therapy (HAART). Patients receiving tenofovir, disoproxil, fumarate (TDF) had an increased prevalence of proximal renal tubular dysfunction and injury but its clinical significance remain controversial. To difine the renal tubulopathy injury among patients with HIV with and without TDF. A cross-sectional study was conducted among HIV positive patients receiving TDF (N= 176) and non TDF regimen (N= 146) at outpatient clinic. All patients were evaluated regarding serum creatinine, electrolytes, phosphate and differing urinary parameters (proteinuria, glycosuria and pyuria). Estimated glomerular filtration rate (GFR) was calculated using CKD-EPI equation. Of 322 participants with mean age of 41.6+-11.4 years and HIV duration of 7.2+-4.3 years, the TDF and non TDF groups were similar on most clinical and demographic factors. GFR was 100.6+- 17.8 mL/min/1.73 m2 in TDF group and 97.5+- 19.6 mL/min/1.73 m2 in non-TDF group (p= 0.143). During evaluation, 3.4% of TDF patients vs. none of the non TDF-patients had hypophosphataemia (< 2.5 mg/dL), 3.9% of TDF-patients vs. 1.3% of non TDF had hypokalemia (< 3.5 mg/dL), and 0.68% of TDF-patients vs. none of non TDF patients had acidosis (< 18 mEq/L) with no statistically significant difference between groups. The proportion of patients with evidence of urine abnormalities was also similar in the two groups (Dipstick proteinuria > 1+, TDF: 17.6% vs. non-TDF 20.5%, p= 0.568, and pyuria; TDF: 27.3% vs. non TDF 20.5%, p= 0.192). Renal impairment, electrolyte disturbances and renal tubulopathy were uncommon among HIV positive patients receiving TDF-based antiretroviral therapy and did not significantly differ between TDF and non TDF regimens
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