The effect of Tenofovir on renal function among Ugandan adults on long-term antiretroviral therapy: a cross-sectional enrolment analysis


BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

DOI: 10.1186/s12981-016-0113-z

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@inproceedings{Salome2016TheEO, title={The effect of Tenofovir on renal function among Ugandan adults on long-term antiretroviral therapy: a cross-sectional enrolment analysis}, author={Tino Salome and Ivan Kasamba and Billy Nsubuga Mayanja and Patrick Kazooba and Jackson Were and Pontiano Kaleebu and Paula Munderi and Judith Nalwadda and Gladys Nakibuuka and Harriet Namugenyi and Rosemary Lubega and Annet Mugisha and Apophia Tereka and Apuuli Kalyebara and Arthur Namara and Diana Nakitto and Deus Wangi and Fred Nume and George Ssemwanga and Gertrude Nabulime and Gladys Nassuna and Gloria Lubega and Ivan Namakoola and Joseph Lutaakome and Lillian Generous and Lydia Matama and Rosemary Massa and Salome Tino and William Nakahima and Anne A. Kapaata and Brian Magambo and Chris M. Parry and Frederick Lyagoba and Jamirah Nazziwa and Maria Nannyonjo and Edward Muhigirwa and Faith Wamalugu and Florence Kabajuma and Hope Grania Nakazibwe and Joan Bwandinga and Juliet Bukenya and Member Zephyrian Kamushaaga and Peter Hughes and Peter M Nkurunziza and Priscilla Agatha Balungi and Simon Mukasa and Sureyah Nassimbwa and Tobias Vudriko and William Senyonga and Willyfred Ochola and Annet Nakimbugwe and Catherine Nampewo and Doreen Nambuba and Erima Naphtali and Grace Barigye and Irene Nakamanya and Jonathan B Levin and J. Kahwa and Joy Namutebi Matovu and Lillian Namayirira and Ruth Namulindwa Lubega and Sandra Nabalayo and Solomon Kaddu}, booktitle={AIDS research and therapy}, year={2016} }