Change in renal function among HIV-infected Koreans receiving tenofovir disoproxil fumarate-backbone antiretroviral therapy: A 3-year follow-up study

Kyoung Hwa Lee, Ji Un Lee, Nam Su Ku, Su Jin Jeong, Sang Hoon Han, JunYong Choi, Young Goo Song, June Myung Kim

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Abstract

Purpose: Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF. Materials and Methods: We prospectively followed 50 HIV-infected Koreans, performing laboratory tests every 3 months during the first year and every 6 months for the next 2 years. Urine N-acetyl-β-D-glucosaminidase (NAG) and plasma cystatin-C were measured using samples collected in the first year. Data on renal function were retrospectively collected on HIV-infected patients receiving first-line TDF (n=40) and in antiretroviral therapy (ART)-naïve patients (n=24) for 3 years. Renal function was evaluated as estimated glomerular filtration rate (eGFR) from serum creatinine [Modification of Diet in Renal Disease (MDRD)] and cystatin-C. Results: The eGFR (cystatin-C) showed significant changes from 0 to 48 wks (p=0.002), with the lowest levels at 24 wks (84.3±18.8 mL/min vs. 90.3±22.5 mL/min, p=0.021 by post hoc test). Urine NAG levels did not differ at 0, 12, 24, and 48 wks, although eGFR (MDRD) significantly decreased from 0 (98.7±18.9 mL/min/1.73 m2) to 144 wks (89.0±14.7 mL/min/1.73 m2) (p=0.010). The first-line TDF group had significantly lower eGFR (MDRD) than the ART-naïve group at 144 wks (89.7 mL/min/1.73 m2 vs. 98.4 mL/ min/1.73 m2, p=0.036). Thirteen (26%) participants experienced a decrease in renal impairment of 10 mL/min/1.73 m2 in eGFR (MDRD) at 144 wks. Conclusion: These data suggest that clinically meaningful renal injury can develop in HIV-infected Koreans receiving long-term TDF.

Original languageEnglish
Pages (from-to)770-777
Number of pages8
JournalYonsei medical journal
Volume58
Issue number4
DOIs
Publication statusPublished - 2017 Jul 1

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Tenofovir
HIV
Kidney
Diet Therapy
Glomerular Filtration Rate
Cystatin C
Therapeutics
Hexosaminidases
Urine

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, Kyoung Hwa ; Lee, Ji Un ; Ku, Nam Su ; Jeong, Su Jin ; Han, Sang Hoon ; Choi, JunYong ; Song, Young Goo ; Kim, June Myung. / Change in renal function among HIV-infected Koreans receiving tenofovir disoproxil fumarate-backbone antiretroviral therapy : A 3-year follow-up study. In: Yonsei medical journal. 2017 ; Vol. 58, No. 4. pp. 770-777.
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title = "Change in renal function among HIV-infected Koreans receiving tenofovir disoproxil fumarate-backbone antiretroviral therapy: A 3-year follow-up study",
abstract = "Purpose: Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF. Materials and Methods: We prospectively followed 50 HIV-infected Koreans, performing laboratory tests every 3 months during the first year and every 6 months for the next 2 years. Urine N-acetyl-β-D-glucosaminidase (NAG) and plasma cystatin-C were measured using samples collected in the first year. Data on renal function were retrospectively collected on HIV-infected patients receiving first-line TDF (n=40) and in antiretroviral therapy (ART)-na{\"i}ve patients (n=24) for 3 years. Renal function was evaluated as estimated glomerular filtration rate (eGFR) from serum creatinine [Modification of Diet in Renal Disease (MDRD)] and cystatin-C. Results: The eGFR (cystatin-C) showed significant changes from 0 to 48 wks (p=0.002), with the lowest levels at 24 wks (84.3±18.8 mL/min vs. 90.3±22.5 mL/min, p=0.021 by post hoc test). Urine NAG levels did not differ at 0, 12, 24, and 48 wks, although eGFR (MDRD) significantly decreased from 0 (98.7±18.9 mL/min/1.73 m2) to 144 wks (89.0±14.7 mL/min/1.73 m2) (p=0.010). The first-line TDF group had significantly lower eGFR (MDRD) than the ART-na{\"i}ve group at 144 wks (89.7 mL/min/1.73 m2 vs. 98.4 mL/ min/1.73 m2, p=0.036). Thirteen (26{\%}) participants experienced a decrease in renal impairment of 10 mL/min/1.73 m2 in eGFR (MDRD) at 144 wks. Conclusion: These data suggest that clinically meaningful renal injury can develop in HIV-infected Koreans receiving long-term TDF.",
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Change in renal function among HIV-infected Koreans receiving tenofovir disoproxil fumarate-backbone antiretroviral therapy : A 3-year follow-up study. / Lee, Kyoung Hwa; Lee, Ji Un; Ku, Nam Su; Jeong, Su Jin; Han, Sang Hoon; Choi, JunYong; Song, Young Goo; Kim, June Myung.

In: Yonsei medical journal, Vol. 58, No. 4, 01.07.2017, p. 770-777.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Change in renal function among HIV-infected Koreans receiving tenofovir disoproxil fumarate-backbone antiretroviral therapy

T2 - A 3-year follow-up study

AU - Lee, Kyoung Hwa

AU - Lee, Ji Un

AU - Ku, Nam Su

AU - Jeong, Su Jin

AU - Han, Sang Hoon

AU - Choi, JunYong

AU - Song, Young Goo

AU - Kim, June Myung

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Purpose: Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF. Materials and Methods: We prospectively followed 50 HIV-infected Koreans, performing laboratory tests every 3 months during the first year and every 6 months for the next 2 years. Urine N-acetyl-β-D-glucosaminidase (NAG) and plasma cystatin-C were measured using samples collected in the first year. Data on renal function were retrospectively collected on HIV-infected patients receiving first-line TDF (n=40) and in antiretroviral therapy (ART)-naïve patients (n=24) for 3 years. Renal function was evaluated as estimated glomerular filtration rate (eGFR) from serum creatinine [Modification of Diet in Renal Disease (MDRD)] and cystatin-C. Results: The eGFR (cystatin-C) showed significant changes from 0 to 48 wks (p=0.002), with the lowest levels at 24 wks (84.3±18.8 mL/min vs. 90.3±22.5 mL/min, p=0.021 by post hoc test). Urine NAG levels did not differ at 0, 12, 24, and 48 wks, although eGFR (MDRD) significantly decreased from 0 (98.7±18.9 mL/min/1.73 m2) to 144 wks (89.0±14.7 mL/min/1.73 m2) (p=0.010). The first-line TDF group had significantly lower eGFR (MDRD) than the ART-naïve group at 144 wks (89.7 mL/min/1.73 m2 vs. 98.4 mL/ min/1.73 m2, p=0.036). Thirteen (26%) participants experienced a decrease in renal impairment of 10 mL/min/1.73 m2 in eGFR (MDRD) at 144 wks. Conclusion: These data suggest that clinically meaningful renal injury can develop in HIV-infected Koreans receiving long-term TDF.

AB - Purpose: Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF. Materials and Methods: We prospectively followed 50 HIV-infected Koreans, performing laboratory tests every 3 months during the first year and every 6 months for the next 2 years. Urine N-acetyl-β-D-glucosaminidase (NAG) and plasma cystatin-C were measured using samples collected in the first year. Data on renal function were retrospectively collected on HIV-infected patients receiving first-line TDF (n=40) and in antiretroviral therapy (ART)-naïve patients (n=24) for 3 years. Renal function was evaluated as estimated glomerular filtration rate (eGFR) from serum creatinine [Modification of Diet in Renal Disease (MDRD)] and cystatin-C. Results: The eGFR (cystatin-C) showed significant changes from 0 to 48 wks (p=0.002), with the lowest levels at 24 wks (84.3±18.8 mL/min vs. 90.3±22.5 mL/min, p=0.021 by post hoc test). Urine NAG levels did not differ at 0, 12, 24, and 48 wks, although eGFR (MDRD) significantly decreased from 0 (98.7±18.9 mL/min/1.73 m2) to 144 wks (89.0±14.7 mL/min/1.73 m2) (p=0.010). The first-line TDF group had significantly lower eGFR (MDRD) than the ART-naïve group at 144 wks (89.7 mL/min/1.73 m2 vs. 98.4 mL/ min/1.73 m2, p=0.036). Thirteen (26%) participants experienced a decrease in renal impairment of 10 mL/min/1.73 m2 in eGFR (MDRD) at 144 wks. Conclusion: These data suggest that clinically meaningful renal injury can develop in HIV-infected Koreans receiving long-term TDF.

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DO - 10.3349/ymj.2017.58.4.770

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