title: Tenofovir-Related Nephropathies in HIV-Infected Patients.
abstract: BACKGROUND
  The number of human immunodeficiency virus (HIV)-infected patients has increased significantly, although the number of deaths due to HIV and acquired immunodeficiency syndrome (AIDS) has dramatically reduced. Highly active antiretroviral therapy (HAART) has increased not only survival but also the risk of deaths caused by other diseases or by long-term side effects of these drugs.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the nephrotoxicity of one of the most common anti-retroviral drugs, tenofovir disoproxil fumarate (TDF).
  
  
  METHODS
  We examined 27 patients with HIV infection (10 women). Patients assumed TDF for a mean period of 8.03 months. Indexes of renal function and serum electrolytes were measured, and glomerular filtration rate was estimated (eGFR). Proteinuria, glycosuria, bicarbonaturia, and phosphaturia were assessed, and renal ultrasound examination was carried out.
  
  
  RESULTS
  Acute kidney injury with glycosuria, bicarbonaturia, and phosphaturia was seen in 22 patients. Substantial recovery of renal function occurred in 19 patients.
  
  
  CONCLUSIONS
  This study highlights that TDF nephrotoxicity is a widely frequent but reversible form of renal damage with preferentially proximal tubular dysfunction. We suggest that all patients at the time of HIV diagnosis should carry out a screening for kidney disease with eGFR assessment, proteinuria, and urine analysis.
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37 00185 Rome, Italy. silvia.lai@uniroma1.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lai
authors.forename: Amalia
authors.initials: A
authors.lastname: Mariotti
authors.forename: Carlo
authors.initials: C
authors.lastname: Lai
authors.forename: Massimo
authors.initials: M
authors.lastname: Testorio
authors.forename: Maria
authors.initials: M
authors.lastname: Carta
authors.forename: Georgie
authors.initials: G
authors.lastname: Innico
authors.forename: Nicla
authors.initials: N
authors.lastname: Frassetti
authors.forename: Marco
authors.initials: M
authors.lastname: Mangiulli
authors.forename: Annarita
authors.initials: A
authors.lastname: D'Angelo
authors.forename: Gaspare E
authors.initials: GE
authors.lastname: Russo
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000139:chemically induced / Q000453:epidemiology; D000068698:Tenofovir / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir