Current guidelines contraindicate TDF use when creatinine clearance (CrCl) falls below 50 ml/min. We report prevalence of abnormal renal function at baseline and factors associated with abnormal renal function from a community cohort in Lesotho

A Pozniak

A Reid

Anon

B Chi

C Franey

Clive Gray

D Schopper

Eric Goemaere

G Struik

Guillaume Jouquet

Helen Bygrave

JC Verhave

JE Gallant

K Barraclough

Katharina Kranzer

Katherine Hilderbrand

L Mulenga

Laura Triviño

Lipontso Makakole

Nathalie Vlahakis

Nathan Ford

O Keiser

R Cohen

R Cooper

S Vrouenraets

SA Grim

English

PubMed

Introduction Current guidelines contraindicate TDF use when creatinine clearance (CrCl) falls below 50 ml/min. We report prevalence of abnormal renal function at baseline and factors associated with abnormal renal function from a community cohort in Lesotho. METHODS: We calculated changes in CrCl from baseline for patients initiated on TDF at 6 and 12 months and the proportion of patients initiated on TDF who developed renal impairment. Screening algorithms were developed using risk factors determined by multivariate analysis. RESULTS: Among 933 adults for whom baseline creatinine was available, 176 (18.9%) presented with a baseline CrCl <50 ml/min. Renal function improved during follow-up. 19 patients who developed renal toxicity during follow up remained on TDF; renal function improved (CrCl≥50 ml/min) in all but 3 of these patients. Among 15 patients with a baseline CrCl <50 ml/min were started in error, none developed severe renal impairment. CONCLUSION: In this setting TDF-associated renal toxicity is rare and mainly transient. Further studies to assess TDF safety at lower CrCl thresholds are warranted

Bygrave, Helen

Kranzer, Katharina

Hilderbrand, Katherine

Jouquet, Guillaume

Goemaere, Eric

Vlahakis, Nathalie

Triviño, Laura

Makakole, Lipontso

Ford, Nathan

Cape Town University OpenUCT

Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho

INTRODUCTION: Current guidelines contraindicate TDF use when creatinine clearance (CrCl) falls below 50 ml/min. We report prevalence of abnormal renal function at baseline and factors associated with abnormal renal function from a community cohort in Lesotho. METHODS: We calculated changes in CrCl from baseline for patients initiated on TDF at 6 and 12 months and the proportion of patients initiated on TDF who developed renal impairment. Screening algorithms were developed using risk factors determined by multivariate analysis. RESULTS: Among 933 adults for whom baseline creatinine was available, 176 (18.9%) presented with a baseline CrCl <50 ml/min. Renal function improved during follow-up. 19 patients who developed renal toxicity during follow up remained on TDF; renal function improved (CrCl≥50 ml/min) in all but 3 of these patients. Among 15 patients with a baseline CrCl <50 ml/min were started in error, none developed severe renal impairment. CONCLUSION: In this setting TDF-associated renal toxicity is rare and mainly transient. Further studies to assess TDF safety at lower CrCl thresholds are warranted

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Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural Lesotho.

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Renal Safety of a Tenofovir-Containing First Line Regimen: Experience from an Antiretroviral Cohort in Rural Lesotho

LSHTM Research Online

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Renal safety of a tenofovir-containing first line regimen: experience from an antiretroviral cohort in rural lesotho.

http://researchonline.lshtm.ac.uk/1166/1/pone.0017609.pdf

Renal Safety of a Tenofovir-Containing First Line Regimen: Experience from an Antiretroviral Cohort in Rural Lesotho

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Cape Town University OpenUCT

Directory of Open Access Journals

Crossref

LSHTM Research Online

MSF Field Research