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Prospective study of renal function in HIV-infected pediatric patients receiving tenofovir-containing HAART regimens

Pere Soler-Palacín1, Susana Melendo, Antoni Noguera-Julian

  • 1Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron University Hospital, Spain. psoler@vhebron.net

AIDS (London, England)
|November 16, 2010
PubMed

Insights

Tenofovir disoproxil fumarate (TDF) use in HIV-infected children is associated with renal tubular dysfunction, including abnormal urine osmolality, decreased phosphate absorption, and proteinuria. Regular monitoring of kidney tubular function is recommended for these pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Tenofovir disoproxil fumarate (TDF) is a key antiretroviral medication used in managing HIV infection.
  • Understanding the long-term renal effects of TDF in pediatric populations is crucial for patient management.
  • Previous studies have indicated potential renal toxicity associated with TDF, necessitating further investigation in children.

Purpose of the Study:

  • To evaluate the impact of tenofovir disoproxil fumarate (TDF) on renal function in HIV-infected pediatric patients.
  • To identify specific markers of renal dysfunction associated with TDF use in this cohort.
  • To provide evidence-based recommendations for monitoring renal health in children on TDF therapy.

Main Methods:

  • A prospective, multicenter study involving HIV-infected pediatric patients (≤18 years) receiving TDF for at least 6 months.
  • Renal function was assessed through urine and serum analyses, including creatinine clearance, urine osmolality, phosphate, and potassium levels.
  • Data analysis focused on changes in renal parameters after a minimum of 6 months of TDF treatment.

Main Results:

  • No significant changes in estimated creatinine clearance were observed in the 40 participating pediatric patients.
  • Abnormalities in renal tubular function were noted, including abnormal urine osmolality (8/37), decreased tubular phosphate absorption (28/38), and proteinuria (33/37).
  • Statistically significant decreases in serum phosphate and potassium levels were observed during TDF treatment, with a negative correlation between phosphate concentration and duration of TDF therapy.

Conclusions:

  • Tenofovir disoproxil fumarate (TDF) use is significantly associated with renal tubular dysfunction in HIV-infected pediatric patients.
  • The findings highlight the importance of assessing tubular function, not just glomerular function, in children on TDF.
  • Periodic monitoring of renal tubular function is recommended for HIV-infected pediatric patients receiving TDF to mitigate potential adverse effects.
Abstract

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