title: The effect of Tenofovir on renal function among Ugandan adults on long-term antiretroviral therapy: a cross-sectional enrolment analysis.
abstract: WHO recommends using Tenofovir containing first line antiretroviral therapy (ART), however, Tenofovir has been reported to be associated with renal impairment and dysfunction. We compared renal function among individuals on Tenofovir and those on non-Tenofovir containing ART.
  
  
  
  In a cross-sectional study of HIV-Positive adults on ART, at enrolment into a prospective cohort to study the long-term complications of ART in Uganda, information on biophysical measurements, medical history, clinical examination and renal function tests (RFTs) was collected. Fractional Tubular phosphate reabsorption and estimated glomerular filtration rate (eGFR) were calculated. Mean values of RFTs and proportions with abnormal RFTs were compared between non-Tenofovir containing (Non-TDF) and Tenofovir containing (TDF-ART) ART regimen groups using a general linear regression model. Durations of TDF exposure were also compared.
  
  
  
  Between July 2013 and October 2014, we enrolled 953 individuals on ART for 6 or more months, median duration on ART was 9.3 years, 385 (40.4 %) were on non-TDF and 568 (59.6 %) on TDF-ART regimens. The proportion of participants with Proteinuria (>30 mg/dl) was higher among the TDF-ART group than the non-TDF ART group. However, in multivariable analysis, there were no significant differences in the adjusted mean differences of eGFR, serum urea, serum creatinine, fractional tubular reabsorption of phosphate and serum phosphates when patients on TDF-ART were compared with those on non-TDF containing ART. There were no differences in renal function even when different durations on Tenofovir were compared.
  
  
  
  We found no differences in renal function among patients on Tenofovir and non-Tenofovir containing ART for almost a decade. Tenofovir based first line ART can therefore safely be initiated even in settings without routine renal function monitoring.
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors: Tino
authors: T
authors: Salome
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda ; MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
authors: Ivan
authors: I
authors: Kasamba
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors: Billy Nsubuga
authors: BN
authors: Mayanja
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors: Patrick
authors: P
authors: Kazooba
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors: Jackson
authors: J
authors: Were
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda ; Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
authors: Pontiano
authors: P
authors: Kaleebu
authors: MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors: Paula
authors: P
authors: Munderi
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000821:virology; D000068698:Tenofovir / Q000008:administration & dosage* / Q000009:adverse effects*; D014454:Uganda; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D000068698:Tenofovir; D003404:Creatinine
keywords: Antiretroviral therapy; HIV; Renal function; Tenofovir; eGFR