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Renal toxicity associated with tenofovir use
Sonia Rodriguez-Nóvoa1, Elena Alvarez, Pablo Labarga
1Hospital Carlos III, Pharmacokinetic & Pharmacogenetic Unit, Department of Infectious Diseases, Calle Sinesio Delgado 10, Madrid 28029, Spain.
Expert Opinion on Drug Safety
|April 14, 2010
Summary
Tenofovir (TFV) can cause kidney tubular dysfunction, especially with long-term use. While severe damage is rare, mild dysfunction is common and may worsen with cumulative exposure.
Area of Science:
- Pharmacology
- Nephrology
- Infectious Diseases
Background:
- Tenofovir (TFV) is a crucial nucleotide analogue for HIV treatment.
- Long-term TFV use raises concerns regarding potential nephrotoxicity.
- Kidney tubular dysfunction is an increasingly reported adverse effect.
Purpose of the Study:
- To review evidence on renal toxicity associated with Tenofovir (TFV).
- To identify predictors of TFV-induced nephrotoxicity.
- To assess the frequency and reversibility of TFV-related kidney damage.
Main Methods:
- Systematic review of relevant publications on TFV safety.
- Analysis of studies reporting cases of TFV-induced tubular dysfunction.
- Examination of clinical data on renal adverse events.
Main Results:
- Clinically significant renal damage from TFV is uncommon in the short-to-mid-term.
- Individuals with pre-existing kidney conditions are at higher risk.
- TFV primarily causes kidney tubular dysfunction, with glomerular abnormalities being less frequent.
- Kidney damage may progress with long-term exposure but is often reversible upon discontinuation.
Conclusions:
- Severe renal damage from TFV is uncommon and multifactorial.
- Mild tubular dysfunction is observed in a significant proportion of patients on TFV.
- The incidence of mild tubular dysfunction increases with cumulative TFV exposure.
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