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Tenofovir-Associated Kidney Dysfunction and Bone Fracture: A Case Report and Literature Review
K K Athish1, Shobhana Nayak Rao2, Venkat H Marimuthu3
1Department of Internal Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.
Cureus
|July 4, 2024
Summary
Long-term tenofovir use in HIV treatment can cause kidney damage and bone fractures due to impaired phosphate absorption. Switching to alternative therapies may improve kidney function and prevent these serious side effects.
Area of Science:
- Nephrology
- Endocrinology
- Infectious Diseases
Background:
- Tenofovir is a key component of HIV antiretroviral therapy.
- Long-term tenofovir use is linked to adverse renal and bone health outcomes.
Observation:
- A 65-year-old woman with HIV developed advanced renal failure and a bone fracture.
- The condition was attributed to hypophosphatemia caused by prolonged tenofovir exposure.
Findings:
- Tenofovir can impair renal phosphate reabsorption, leading to hypophosphatemia.
- This disruption affects mineral metabolism, increases parathyroid hormone, and reduces bone mineral density.
- Associated renal issues include decreased glomerular filtration rate and tubular dysfunction.
Implications:
- Early monitoring of kidney function in patients on tenofovir is crucial.
- Considering alternative antiretroviral therapies can mitigate tenofovir-related nephrotoxicity and bone disease.
- Managing these side effects is vital for long-term patient health.
Keywords:
acquired immune deficiency syndrome (aids)avascular necrosis of femuravascular necrosis of the hipdrug-induced acute renal failurefemur intertrochanteric fracturehighly active antiretroviral therapy (haart)human immunodeficiency virus (hiv)kidney failuretenofovir alafenamide (taf)tenofovir disoproxil fumarate (tdf)
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