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Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort
Little evidence is available for the incidence of chronic kidney disease (CKD) and rate of estimated glomerular filtration rate (eGFR) decrement among Asians with low body weight who are susceptible to tenofovir disoproxil fumarate (TDF) nephrotoxicity. In this 12-year observational cohort in Tokyo,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359640/ https://www.ncbi.nlm.nih.gov/pubmed/28282247 http://dx.doi.org/10.1089/apc.2016.0286 |
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author | Suzuki, Soichiro Nishijima, Takeshi Kawasaki, Yohei Kurosawa, Takuma Mutoh, Yoshikazu Kikuchi, Yoshimi Gatanaga, Hiroyuki Oka, Shinichi |
author_facet | Suzuki, Soichiro Nishijima, Takeshi Kawasaki, Yohei Kurosawa, Takuma Mutoh, Yoshikazu Kikuchi, Yoshimi Gatanaga, Hiroyuki Oka, Shinichi |
author_sort | Suzuki, Soichiro |
collection | PubMed |
description | Little evidence is available for the incidence of chronic kidney disease (CKD) and rate of estimated glomerular filtration rate (eGFR) decrement among Asians with low body weight who are susceptible to tenofovir disoproxil fumarate (TDF) nephrotoxicity. In this 12-year observational cohort in Tokyo, we examined 1383 treatment-naïve HIV-1-infected Asians [720 started TDF-containing (TDF group) and 663 started non-TDF-containing (control) combination antiretroviral therapy (cART)]. The CKD incidence was calculated, and the effect of TDF use on CKD development was estimated using logistic regression. The eGFR slopes, before and after cART initiation, were estimated using mixed-effects linear spline models. Most patients were males (median weight, 62.6 kg; 83% started ritonavir-boosted protease inhibitors; median observation duration, 5.08 years). CKD developed in 150 patients (10.8%), with an incidence of 20.6 per 1000 person-years [confidence interval (95% CI), 17.6–24.2]. None developed end-stage renal disease. TDF use was associated with CKD [odds ratio (OR), 1.8; 95% CI, 1.00–3.13; p = 0.052]. The cumulative mean loss in the TDF group, relative to the control, increased over time after 1, 4, and 8 years of TDF exposure (−3.8, −5.5, and −9.0 mL/min/1.73 m(2), respectively; p < 0.0001). The eGFR rapidly declined during the first 3 months of cART, particularly in the TDF group (−26.4 vs. −7.4 mL/min/1.73 m(2)/year in the control). In the TDF group, cART introduction was significantly associated with a faster rate of eGFR decline (from −0.44 to −2.11 mL/min/1.73 m(2)/year; p = 0.010), whereas in the control, the difference was not significant. For HIV-1-infected Asian patients with low body weight, TDF-containing cART is associated with CKD and faster eGFR declines. |
format | Online Article Text |
id | pubmed-5359640 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Mary Ann Liebert, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53596402017-05-02 Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort Suzuki, Soichiro Nishijima, Takeshi Kawasaki, Yohei Kurosawa, Takuma Mutoh, Yoshikazu Kikuchi, Yoshimi Gatanaga, Hiroyuki Oka, Shinichi AIDS Patient Care STDS Clinical and Epidemiologic Research Little evidence is available for the incidence of chronic kidney disease (CKD) and rate of estimated glomerular filtration rate (eGFR) decrement among Asians with low body weight who are susceptible to tenofovir disoproxil fumarate (TDF) nephrotoxicity. In this 12-year observational cohort in Tokyo, we examined 1383 treatment-naïve HIV-1-infected Asians [720 started TDF-containing (TDF group) and 663 started non-TDF-containing (control) combination antiretroviral therapy (cART)]. The CKD incidence was calculated, and the effect of TDF use on CKD development was estimated using logistic regression. The eGFR slopes, before and after cART initiation, were estimated using mixed-effects linear spline models. Most patients were males (median weight, 62.6 kg; 83% started ritonavir-boosted protease inhibitors; median observation duration, 5.08 years). CKD developed in 150 patients (10.8%), with an incidence of 20.6 per 1000 person-years [confidence interval (95% CI), 17.6–24.2]. None developed end-stage renal disease. TDF use was associated with CKD [odds ratio (OR), 1.8; 95% CI, 1.00–3.13; p = 0.052]. The cumulative mean loss in the TDF group, relative to the control, increased over time after 1, 4, and 8 years of TDF exposure (−3.8, −5.5, and −9.0 mL/min/1.73 m(2), respectively; p < 0.0001). The eGFR rapidly declined during the first 3 months of cART, particularly in the TDF group (−26.4 vs. −7.4 mL/min/1.73 m(2)/year in the control). In the TDF group, cART introduction was significantly associated with a faster rate of eGFR decline (from −0.44 to −2.11 mL/min/1.73 m(2)/year; p = 0.010), whereas in the control, the difference was not significant. For HIV-1-infected Asian patients with low body weight, TDF-containing cART is associated with CKD and faster eGFR declines. Mary Ann Liebert, Inc. 2017-03-01 2017-03-01 /pmc/articles/PMC5359640/ /pubmed/28282247 http://dx.doi.org/10.1089/apc.2016.0286 Text en © Soichiro Suzuki, et al., 2017; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Clinical and Epidemiologic Research Suzuki, Soichiro Nishijima, Takeshi Kawasaki, Yohei Kurosawa, Takuma Mutoh, Yoshikazu Kikuchi, Yoshimi Gatanaga, Hiroyuki Oka, Shinichi Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title | Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title_full | Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title_fullStr | Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title_full_unstemmed | Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title_short | Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1–Infected Treatment-Naïve Asian Patients: Results from 12-Year Observational Cohort |
title_sort | effect of tenofovir disoproxil fumarate on incidence of chronic kidney disease and rate of estimated glomerular filtration rate decrement in hiv-1–infected treatment-naïve asian patients: results from 12-year observational cohort |
topic | Clinical and Epidemiologic Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359640/ https://www.ncbi.nlm.nih.gov/pubmed/28282247 http://dx.doi.org/10.1089/apc.2016.0286 |
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