Tenofovir-related Fanconi syndrome with nephrogenic diabetes insipidus in a patient with acquired immunodeficiency syndrome: the role of lopinavir-ritonavir-didanosine.
Tenofovir-related tubular damage, like all other recently reported cases, occurred in patients receiving the protease inhibitor (PI) ritonavir, often with lopinavir. Increased plasma concentrations of didanosine were also observed after the addition of tenofovir. It was suspected that tenofovir with PIs interacted with renal organic anion transporters, leading to nephrotoxic tubular concentrations of tenofovir and systemic accumulation of didanosine. Until there is a better understanding of these interactions, close monitoring is recommended for patients receiving tenofovir, PIs, and didanosine.
Rollot
Florence
F
Internal Medicine, Cochin and Saint Vincent de Paul Hospital, Paris, France.
Nazal
Eve-Marie
EM
Chauvelot-Moachon
Laurence
L
Kélaïdi
Charikleia
C
Daniel
Nathalie
N
Saba
Mona
M
Abad
Sebastien
S
Blanche
Philippe
P
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000225:Adenine / Q000031:analogs & derivatives*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018500:Diabetes Insipidus, Nephrogenic / Q000150:complications*; D016049:Didanosine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005198:Fanconi Syndrome / Q000139:chemically induced / Q000150:complications*; D006801:Humans; D061466:Lopinavir; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D011744:Pyrimidinones / Q000627:therapeutic use; D019438:Ritonavir / Q000627:therapeutic use; D000068698:Tenofovir
D019380:Anti-HIV Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D011744:Pyrimidinones; D061466:Lopinavir; D000068698:Tenofovir; D000225:Adenine; D016049:Didanosine; D019438:Ritonavir