title: Assessing recovery of renal function after tenofovir disoproxil fumarate discontinuation.
abstract: Impaired renal function caused by tenofovir disoproxil fumarate (TDF) is considered reversible by discontinuing TDF administration, but there are occasional cases of incomplete recovery. We investigated the recovery of renal function after the discontinuation of TDF. Subjects comprised patients who had been started on TDF but in whom it was later discontinued because of impaired renal function. We investigated renal function until 96 weeks after the discontinuation of TDF, and the duration of TDF administration, up to May 2010. TDF was discontinued because of impaired renal function in 21 of 766 patients (2.7%). Following discontinuation, a significant recovery was seen in eGFR (p = 0.003). The median duration of administration was 28 days (6-941 days) in 9 patients whose eGFR recovered to pre-administration levels, 405 days (250-1,379) in 7 patients in whom mild recovery was seen, and 1,110 days (421-1,470) in 5 patients in whom eGFR was much lower than at the time of discontinuation. A significant correlation was seen between the eGFR recovery rate and the duration of TDF administration. TDF administration was discontinued because of renal impairment in 2.7% of patients. The duration of TDF administration was short in patients whose renal function recovered to pre-administration levels, but patients in whom sufficient recovery was not seen after discontinuation had received TDF over long periods and included many whose renal function gradually declined, even after discontinuation. Recovery of renal function after discontinuation of TDF is likely affected by the duration of TDF administration.
authors.affiliation: Department of Pharmacy, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan. yoshino@onh.go.jp
authors.forename: Munehiro
authors.initials: M
authors.lastname: Yoshino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yagura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kushida
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yonemoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Bando
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Keishiro
authors.initials: K
authors.lastname: Yajima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kasai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Dai
authors.initials: D
authors.lastname: Watanabe
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nishida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kuwahara
authors.forename: Tomoko
authors.initials: T
authors.lastname: Uehira
authors.forename: Takuma
authors.initials: T
authors.lastname: Shirasaka
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007564:Japan; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000068698:Tenofovir; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine