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Related Concept Videos

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),...
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
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...
Hepatic Drug Clearance: Effect of Protein Binding01:09

Hepatic Drug Clearance: Effect of Protein Binding

Hepatic clearance is influenced by protein binding based on the drug's extraction ratio. Drugs with high extraction ratios are considered flow-limited and remain unaffected by protein binding during hepatic clearance. On the other hand, drugs with low extraction ratios may be impacted by plasma protein binding, although the extent of this influence depends on the fraction of the drug bound.
For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...
Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles.

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Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
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Tenofovir-associated proteinuria.

Mark D Kelly1, Abby Gibson, Harry Bartlett

  • 1Brisbane Sexual Health and HIV Service, Brisbane, Queensland, Australia. mark_d_kelly@health.qld.gov.au

AIDS (London, England)
|August 10, 2012
PubMed
Summary

Tenofovir, a medication for HIV, can cause proteinuria, a kidney issue. This condition is often reversible by stopping tenofovir treatment, highlighting a key clinical consideration for HIV patients.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Tenofovir is a widely used antiretroviral medication for HIV treatment.
  • Kidney-related side effects of tenofovir require ongoing clinical monitoring.

Purpose of the Study:

  • To investigate the incidence and reversibility of proteinuria in HIV patients on tenofovir therapy.
  • To identify factors associated with tenofovir-induced proteinuria.

Main Methods:

  • Retrospective cohort study of 153 HIV patients.
  • Analysis of proteinuria incidence after more than 1 year of tenofovir use.
  • Assessment of reversibility upon drug cessation.

Main Results:

  • Proteinuria occurred in 27% of patients on tenofovir for over 1 year.
  • Concomitant protease inhibitor use and cumulative tenofovir exposure were linked to proteinuria.
  • Proteinuria resolved in 11 of 12 patients who discontinued tenofovir.

Conclusions:

  • Tenofovir can induce reversible proteinuria in HIV patients.
  • Clinicians should monitor for proteinuria in patients receiving tenofovir.
  • Discontinuation of tenofovir is an effective strategy for managing this side effect.