title: Reversibility of renal dysfunction after discontinuation of tenofovir.
abstract: The association of tenofovir (TDF) with nephrotoxicity has been a controversial issue. Few studies are published regarding the reversibility of renal dysfunction once TDF is discontinued. Studies have yet to be conducted in an urban, non-white patient population, making this one of the largest studies observing a non-white cohort. The objective of this study was to determine whether the decline in creatinine clearance (CrCL) associated with TDF use is reversible once TDF is discontinued in a non-white patient population.
  
  
  
  This single-center, retrospective, chart review was performed at an urban outpatient HIV clinic. Patients who had been switched from tenofovir to zidovudine or abacavir because of a decline in renal function were included. The primary endpoint was the percentage of patients who regained full, moderate, mild, or no recovery of CrCl.
  
  
  
  Sixty-two patients were included. The mean age was 50 years old, 82% were black, and 66% were males with a mean baseline CrCL of 76 ml/min. Mean difference in CrCL from baseline to 12 months post-TDF was shown to be -11.34 ml/min. After a 1-year follow up period, 37.5% of patients had a full recovery of their baseline CrCL. An additional 41% of patients achieved a moderate recovery (80%-99% of baseline CrCL) and 17.9% patients had a mild recovery (50%-79% of baseline CrCL). Two patients required dialysis. The percent of patients with an undetectable HIV RNA while on a TDF-containing regimen was 67.1% compared with 74.6% on alternative ART.
  
  
  
  Renal dysfunction caused by TDF was fully reversible in 37.5% of patients. Improvement to at least 50% of baseline was seen in 96.4% of patients. Viral suppression was not compromised when patient was switched from TDF to an alternative nucleoside reverse transcriptase inhibitor.
authors.forename: Agnes
authors.initials: A
authors.lastname: Cha
authors.forename: Ashley R
authors.initials: AR
authors.lastname: Besignano-Long
authors.forename: Nechama
authors.initials: N
authors.lastname: Rothberger
authors.forename: Bupendra
authors.initials: B
authors.lastname: Shah
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000208:ethnology; D000328:Adult; D001741:Black or African American; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000188:drug therapy* / Q000209:etiology; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000068698:Tenofovir / Q000009:adverse effects* / Q000627:therapeutic use; D014505:Urban Population
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir