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Smoking, female gender and PI use are associated with decreasing renal function in TDF-containing HAART
© Uglietti et al; licensee BioMed Central Ltd. 2010
Published: 8 November 2010
Purpose of the study
Nephrotoxicity of tenofovir (TDF)-containing HAART may be associated to several factors related to treatment or to patient's characteristics. We tried to assess Glomerular Filtration Rate (GFR) changes and their relationship with multiple clinical parameters in an Italian cohort receiving a TDF-containing HAART.
OSMA-1 (Observational Study on Metabolic Abnormalities), a multicenter Italian study, was designed to evaluate since February 2008 the efficacy and the safety of TDF-based regimen in a real-life clinical setting. HIV infected, therapy naïve subjects were enrolled. GFR was estimated using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Statistical analyses used a parametric test and a mixed model was used to analysis changes from baseline to 6, 12, and 24 months, with the different variables as fixed effect plus visit (categorical) and baseline value (continuous as covariate).
Summary of results
Our data suggest that long-term use of TDF is associated with a modest decline in GFR that occurs predominantly at the beginning (in the first 6 months) of therapy in HAART-naive women. However, the decline is small, does not seem to worsen over time, and may not have a relevant clinical effect. A decreasing GFR was also found in elder patients, in smokers and when a boosted PI is used.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.