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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...

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Related Experiment Video

Updated: Jun 23, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
05:46

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

Published on: April 9, 2014

Tenofovir-associated renal and bone toxicity.

Clare L N Woodward1, A M Hall, I G Williams

  • 1The Mortimer Market Centre, Camden PCT, London, UK. Clare.Woodward@camdenpct.nhs.uk

HIV Medicine
|May 23, 2009
PubMed
Summary

Tenofovir (TDF) can cause kidney damage, including Fanconi syndrome and bone problems like osteomalacia, in HIV patients. Early screening for proximal tubular toxicity is recommended to monitor TDF side effects.

Related Experiment Videos

Last Updated: Jun 23, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
05:46

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

Published on: April 9, 2014

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Tenofovir (TDF) is a widely used antiretroviral medication for HIV treatment.
  • Potential renal and bone toxicities associated with TDF therapy require careful monitoring.
  • Understanding the clinical presentation and pathogenic mechanisms of TDF toxicity is crucial for patient management.

Purpose of the Study:

  • To describe the clinical presentation of renal and bone abnormalities in HIV patients treated with TDF.
  • To identify appropriate screening methods for TDF-associated toxicity.
  • To elucidate the pathogenic mechanism of TDF-induced renal impairment.

Main Methods:

  • Retrospective case series of HIV-infected patients referred to a specialist HIV renal clinic.
  • Inclusion criteria: TDF as the primary cause of renal impairment, with available pre- and post-treatment data.
  • Data collection via case note review and clinic databases.

Main Results:

  • Twenty-two patients (1.6%) developed TDF-associated renal toxicity, all with normal baseline creatinine.
  • Common presentations included proteinuria, Fanconi syndrome (8 patients), and bone pain with osteomalacia (12 patients).
  • Proximal tubular dysfunction, evidenced by tubular proteinuria, reduced phosphate transport, and glycosuria, was identified as the likely pathogenic mechanism.

Conclusions:

  • Renal toxicity is a significant concern in patients receiving TDF.
  • Clinical manifestations include renal dysfunction, Fanconi syndrome, and osteomalacia.
  • Proximal tubular toxicity is a common mechanism underlying TDF-associated adverse effects.