Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Aug 30;13(1):28.
doi: 10.1186/s12981-016-0113-z. eCollection 2016.

The effect of Tenofovir on renal function among Ugandan adults on long-term antiretroviral therapy: a cross-sectional enrolment analysis

Tino Salome  1 , Ivan Kasamba  2 , Billy Nsubuga Mayanja  1 , Patrick Kazooba  1 , Jackson Were  1 , Pontiano Kaleebu  3 , Paula Munderi  1 ; CoLTART study team
Collaborators, Affiliations
Randomized Controlled Trial

The effect of Tenofovir on renal function among Ugandan adults on long-term antiretroviral therapy: a cross-sectional enrolment analysis

Tino Salome et al. AIDS Res Ther. .

Abstract

Background: WHO recommends using Tenofovir containing first line antiretroviral therapy (ART), however, Tenofovir has been reported to be associated with renal impairment and dysfunction. We compared renal function among individuals on Tenofovir and those on non-Tenofovir containing ART.

Methods: In a cross-sectional study of HIV-Positive adults on ART, at enrolment into a prospective cohort to study the long-term complications of ART in Uganda, information on biophysical measurements, medical history, clinical examination and renal function tests (RFTs) was collected. Fractional Tubular phosphate reabsorption and estimated glomerular filtration rate (eGFR) were calculated. Mean values of RFTs and proportions with abnormal RFTs were compared between non-Tenofovir containing (Non-TDF) and Tenofovir containing (TDF-ART) ART regimen groups using a general linear regression model. Durations of TDF exposure were also compared.

Results: Between July 2013 and October 2014, we enrolled 953 individuals on ART for 6 or more months, median duration on ART was 9.3 years, 385 (40.4 %) were on non-TDF and 568 (59.6 %) on TDF-ART regimens. The proportion of participants with Proteinuria (>30 mg/dl) was higher among the TDF-ART group than the non-TDF ART group. However, in multivariable analysis, there were no significant differences in the adjusted mean differences of eGFR, serum urea, serum creatinine, fractional tubular reabsorption of phosphate and serum phosphates when patients on TDF-ART were compared with those on non-TDF containing ART. There were no differences in renal function even when different durations on Tenofovir were compared.

Conclusions: We found no differences in renal function among patients on Tenofovir and non-Tenofovir containing ART for almost a decade. Tenofovir based first line ART can therefore safely be initiated even in settings without routine renal function monitoring.

Keywords: Antiretroviral therapy; HIV; Renal function; Tenofovir; eGFR.

PubMed Disclaimer

References

    1. WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva: World Health Organization; 2013. http://www.who.int/hiv/pub/guidelines/arv2013. Accessed 26 Jan 2016.
    1. Ministry of Health, Republic of Uganda. Addendum to the national antiretroviral treatment guidelines. December 2013. http://preventcrypto.org/wp-content/uploads/2012/07/Uganda-National-ART-.... Accessed 15 Jan 2015.
    1. Ministry of Health, Republic of Kenya, (NASCOP). NAaSCP. Guidelines on use of antiretroviral drugs for treating and preventing HIV infection: a rapid advice, 2014. http://guidelines.health.go.ke:8000/media/Rapid_Advice_Booklet_2014_July.... Accessed 17 Feb 2016.
    1. Ministry of Health and Social Welfare, The United Republic of Tanzania, Programme. NAC. The United Republic of Tanzania. National guidelines for the management of HIV and AIDS. 5th edn, May, 2015. http://www.nacp.go.tz/site/publications/care-and-treatment/ NationalGuidelineforManagementHIV.pdf. Accessed 15 Feb 2016.
    1. Hall AM, Hendry BM, Nitsch D, Connolly JO. Tenofovir-associated kidney toxicity in HIV-infected patients: a review of the evidence. Am J Kidney Dis. 2011;57:773–780. doi: 10.1053/j.ajkd.2011.01.022. - DOI - PubMed

Publication types

MeSH terms