title: Nephrotoxicity, including acquired Fanconi's syndrome, caused by adefovir dipivoxil - is there a safe dose?
abstract: OBJECTIVE
  Adefovir dipivoxil (ADV) is an oral bioavailable prodrug of adefovir that possesses potent in vitro activity against hepadnaviruses, retroviruses and herpes viruses. ADV is excreted unchanged in the urine through glomerular filtration and tubular secretion and is known to be nephrotoxic at doses of 60mg daily and above. Thus, the long-term safety of ADV, particularly nephrotoxicity, is a major concern. Our objective is to comment on the nephrotoxcicity of low-dose (10mg daily) ADV through a case report.
  
  
  CONCLUSIONS
  The clinical features of nephrotoxicity because of ADV are described. A case report of acquired Fanconi's syndrome in a chronic hepatitis B patient treated with ADV 10mg daily is used to illustrate several key aspects.
  
  
  CONCLUSIONS
  Adefovir dipivoxil can be nephrotoxic at conventional dosage and therefore, patients treated with long-term ADV should have regular monitoring of renal function, and calcium and phosphate levels.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong. stl168@hotmail.com
authors.forename: S-T
authors.initials: ST
authors.lastname: Law
authors.forename: K K
authors.initials: KK
authors.lastname: Li
authors.forename: Y Y
authors.initials: YY
authors.lastname: Ho
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy; D006801:Humans; D063065:Organophosphonates / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000225:Adenine; C106812:adefovir dipivoxil