[Acute renal failure and hypercalcemia in an AIDS patient on tenofovir and low-dose vitamin D therapy with immune reconstitution inflammatory syndrome].
BACKGROUND
Tenofovir-containing antiviral therapy might result in acute renal failure and is able to induce tubular dysfunction with hypocalcemia. On the other hand, hypercalcemia induced by intoxication with colecalciferol has been described to induce renal failure in HIV-positive individuals as well. Here, the authors describe the unusual case of reversible renal failure due to hypercalcemia in a patient with low-dose colecalciferol substitution treated with tenofovir.


METHODS
A 31-year-old HIV-positive female, CDC stage C3, was admitted to the authors' hospital with progressive renal failure and hypercalcemia. Antiretroviral therapy consisted of tenofovir and emtricitabine in combination with efavirenz. Additionally, she was on low-dose vitamin D(3) substitution (25 microg/d) and calcium supplementation (500 mg/d) due to systemic steroid treatment.


CONCLUSIONS
Additionally to regular control of renal function, serologic level of calcium should be supervised in patients concomitantly treated with tenofovir and colecalciferol.
Klinik für Pneumologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Hannover, Germany. Lavae-Mokhtari.Mahyar@mh-hannover.de
Mahyar
M
Lavae-Mokhtari
Somayeh
S
Mohammad-Khani
Reinhold Ernst
RE
Schmidt
Matthias
M
Stoll
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D058186:Acute Kidney Injury / Q000139:chemically induced*; D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects; D002118:Calcium / Q000008:administration & dosage / Q000009:adverse effects; D002762:Cholecalciferol / Q000008:administration & dosage / Q000009:adverse effects*; D003521:Cyclopropanes; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D000068679:Emtricitabine; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced* / Q000188:drug therapy; D007677:Kidney Function Tests; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy; D063065:Organophosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control; D000068698:Tenofovir
D000305:Adrenal Cortex Hormones; D000480:Alkynes; D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D063065:Organophosphonates; D003841:Deoxycytidine; D002762:Cholecalciferol; D000068698:Tenofovir; D000068679:Emtricitabine; D000225:Adenine; C098320:efavirenz; D002118:Calcium