Reduced kidney function in tenofovir disoproxil fumarate based regimen and associated factors: A hospital based prospective observational study in Ethiopian patients
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Date
2018-02
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Addis Ababa Universty
Abstract
Reduced kidney function in tenofovir disoproxil fumarate based regimen and associated
factors: A hospital based prospective observational study in Ethiopian patients
Taklo Simeneh
Addis Ababa University, 2018
Tenofovir Disoproxil Fumarate (TDF), a drug broadly used in combination antiretroviral therapy
(cART), is associated with renal dysfunction but the prevalence varied from country to country
and it is not known in Ethiopia. TDF has been in use in Ethiopia since 2014. The objectives of
this study were to assess prevalence of renal dysfunction and risk factors associated with it and
the mean change in estimated glomerular filtration rate (eGFR) in human immunodeficiency
virus (HIV) infected patients receiving TDF based antiretroviral regimen at Tikur Anbessa
Specialized Hospital (TASH). It was a hospital based prospective cohort study. The study
participants were treatment naïve HIV infected patients initiating TDF containing combination
antiretroviral therapy or switched to because of adverse events. Multivariable logistic analysis
was used to identify variables which have significant association.
Total of 63 study participants were studied, 16 (25.4%) of whom had greater than 25% fall in
eGFR relative to baseline. Only age greater than 50 years old, CD4 count less than
200cells/mm3, and proteinuria were significantly associated with renal dysfunction in
multivariable logistic regression. There was -8.4 ml/min/1.73m2 mean change in eGFR relative
to baseline at six month of study. In conclusion, the renal dysfunction (defined as greater than
25% decline in eGFR) was found in a quarter of the study population. The long term impact and
the clinical implication of it are not clear.
Future prospective study is required with large sample size and long duration to ascertain the
prevalence of acute kidney injury (AKI) and its progression to chronic kidney disease (CKD).
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Keywords
Tenofovir Disoproxil Fumarate (TDF), TDF based antiretroviral regimen, renal dysfunction.