title: Incidence and risk factors for tenofovir-associated renal function decline among Thai HIV-infected patients with low-body weight.
abstract: OBJECTIVE
  we aimed at determining the incidence and factors for TDF-associated renal function decline among Thai HIV-infected patients.
  
  
  METHODS
  retrospective and prospective cohort studies were conducted. We enrolled HIV-infected adults who had initiated TDF. Renal function decline that was defined by a decrease of 25% in glomerular filtration rate (GFR) from the baseline. Factors associated with the renal function decline were determined.
  
  
  RESULTS
  a total of 405 patients with a median (IQR) body weight of 56.5 (50.5-65.0) kg were enrolled. All but four (99%) were antiretroviral treatment-experience patients. A median (IQR) duration of receiving TDF was 16 (8-21) months. Of these, 78 (19.3%) patients had a 25% decrease in GFR with the incidence rate of 16.2 per 100 person-years. By Kaplan-Meier survival analysis, median time to a 25% decrease in GFR was 28 [95% confidence interval (CI) 25.2-30.8] months. By multiple logistic regression, lower body weight [odds ratio (OR) 1.15 per 5 kg, 95% CI 1.00-1.33], lower body mass index (BMI) (OR 2.26 per 1 kg/m(2), 95% CI 1.74-2.94), baseline GFR (OR 1.62 per 10 ml/min/1.73m(2), 95% CI 1.39-1.88), protease inhibitor (OR 2.12, 95% CI 1.15-3.92), and nephrotoxic drug (OR 3.16, 95% CI 1.44-6.98) were statistically significant factors associated with a 25% decrease in GFR.
  
  
  CONCLUSIONS
  the study revealed high incidence of TDF-associated renal function decline among patients with low-body weight and BMI. Additional risk factors were baseline GFR, receiving protease inhibitor, and nephrotoxic drugs. Close monitoring of renal function is warranted among patients with these risk factors.
authors.affiliation: Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330,Thailand.
authors.forename: Kessarin
authors.initials: K
authors.lastname: Chaisiri
authors.forename: Chureeratana
authors.initials: C
authors.lastname: Bowonwatanuwong
authors.forename: Narat
authors.initials: N
authors.lastname: Kasettratat
authors.forename: Sasisopin
authors.initials: S
authors.lastname: Kiertiburanakul
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D004347:Drug Interactions; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000139:chemically induced*; D012189:Retrospective Studies; D012307:Risk Factors; D000068698:Tenofovir; D013785:Thailand
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine