Renal function outcomes in patients receiving TDF-containing antiretroviral therapy:
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Date
2018
Authors
Kalemeera, Francis
Oberholster, Carla
Segamwenge, Innocent
Kibuule, Dan
Naikaku, Ester
Mwangana, M.
Godman, Brian
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Pharmaceutical Sciences and Research
Abstract
Introduction and Aims: Combination antiretroviral therapy (cART) has improved morbidity and mortality in patients with HIV across countries including countries in sub-Sahara Africa. However, cART is associated with renal impairment. The lack of pre-cART data in a recently published study limited the discussion on renal-based treatment outcomes with cART, which could have important clinical implications. Consequently, the aim of this paper is to correct this.
Methods: Longitudinal retrospective study, with renal function assessed pre-cART and at various time points on cART using the Cockcroft-Gault method. The data source was the patients’ care booklets.
Results: 71 patients were included. The majority were adults and female. Before cART initiation, 70.4% and 29.6% had abnormal and normal CrCl, respectively. CrCl was normalised in 24% of patients, while abnormal in the remainder. The mean (median) time to normalisation was 47.4 (33.7) months, observed more in paediatric than adult patients (p = 0.014). However, in paediatric patients, normalisation took longer than in adult patients. The reduction in CrCl, was observed at variable time points. 9/16 patients experienced a decline during first-line cART and 7 of these were receiving TDF. 7/16 experienced this during second-line cART and 6 were receiving TDF.
Conclusion: HIV is typically the cause of renal impairment prior to cART, with TDF likely to be the cause of renal impairment during cART. Consequently, co-administration of TDF with other nephrotoxic drugs should be undertaken with caution if unavoidable. Overall, improvement in renal impairment was faster in adults.
Description
Research article
Keywords
Research Subject Categories::MEDICINE::Physiology and pharmacology::Pharmacological research::Pharmacology
Citation
Kalemeera, F., Oberholster, C., Segamwenge, I., Kibuule, D., Naikaku, E., Mwangana, M., & Godman, B. (2018). Renal function outcomes in patients receiving TDF-containing antiretroviral therapy: A retrospective pilot study in Namibia. International Journal of Pharmaceutical Sciences and Research, 9(10), 4273-4279.