title: Drug-induced acute interstitial nephritis mimicking acute tubular necrosis after initiation of tenofovir-containing antiretroviral therapy in patient with HIV-1 infection.
abstract: We describe a case of 68-year-old Japanese man with HIV-1 infection who developed acute kidney injury with prominent tubular dysfunction immediately after starting tenofovir-containing antiretroviral therapy. Antiretroviral therapy was discontinued in two weeks but renal function, as well as tubular function, did not shown full recovery even at a 3-year follow-up examination. Acute tubular necrosis, a rare but well-known side effect of tenofovir, was suspected, but kidney biopsy confirmed interstitial nephritis. It is important to distinguish drug-induced interstitial nephritis from acute tubular necrosis, because early steroid administration can improve renal dysfunction caused by acute interstitial nephritis.
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishijima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yazaki
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hinoshita
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tasato
authors.forename: Kazufusa
authors.initials: K
authors.lastname: Hoshimoto
authors.forename: Katsuji
authors.initials: K
authors.lastname: Teruya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000208:Acute Disease; D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D007668:Kidney / Q000473:pathology; D007683:Kidney Tubular Necrosis, Acute / Q000175:diagnosis*; D008297:Male; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000175:diagnosis*; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D000068698:Tenofovir
chemical_list: D044966:Anti-Retroviral Agents; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine