Objectives The aim of our study was to assess the impact of plasma HIV-1 RNA level [viral load (VL)] variation and tenofovir exposure on kidney functions by analysing changes in calculated glomerular filtration rates (GFRs) over a 48 week period in patients with mild renal impairment. Patients and methods A prospective observational study that included data from all consecutive HIV-infected patients who attended a metabolic clinic was conducted. Included were adult, antiretroviral (ARV)-experienced, tenofovir-naive patients, whose kidney functions were evaluated by calculated GFR using the simplified Modification of Diet in Renal Disease study equation (MDRD). Tenofovir-exposed patients were patients who initiated tenofovir therapy at baseline and tenofovir-unexposed patients were patients whose ARV therapy did not include tenofovir. Participants were stratified into three sub-groups according to the plasma HIV-1 RNA (VL) changes observed: sub-groups 1, 2 and 3 were patients with stable VL </=50 copies/mL, >0.5 log(10) VL increases and >0.5 VL log(10) decreases, respectively. Results Ninety-nine patients were enrolled and included in the analysis. Within the tenofovir-unexposed group, GFRs remained stable (ANOVA, P = 0.94) over the follow-up period. Within the tenofovir-exposed group, mean GFR changes varied significantly by sub-group (ANOVA, P < 0.01). In particular, GFR changes in sub-group 3 (+8.4 +/- 12.4 mL/min) were different from those seen in sub-group 1 (-1.0 +/- 8.8 mL/min) (P < 0.05) and sub-group 2 (-4.6 +/- 8.8 mL/min) (P < 0.01). Conclusions Observed improvements in GFR that occurred as a consequence of highly active ARV therapy-induced viral suppression may have more than offset any potential negative effects of tenofovir on renal function.

Glomerular filtration rates in HIV-infected patients treated with and without tenofovir: a prospective, observational study / Guaraldi, Giovanni; Roverato, A.; Giovanardi, C.; Ravera, F.; Squillace, N.; Orlando, Gabriella; Cappelli, Gianni; Esposito, Roberto; Palella, F.. - In: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. - ISSN 0305-7453. - STAMPA. - 63 (2):(2009), pp. 374-379. [10.1093/jac/dkn499]

Glomerular filtration rates in HIV-infected patients treated with and without tenofovir: a prospective, observational study.

GUARALDI, Giovanni;ORLANDO, Gabriella;CAPPELLI, Gianni;ESPOSITO, Roberto;
2009

Abstract

Objectives The aim of our study was to assess the impact of plasma HIV-1 RNA level [viral load (VL)] variation and tenofovir exposure on kidney functions by analysing changes in calculated glomerular filtration rates (GFRs) over a 48 week period in patients with mild renal impairment. Patients and methods A prospective observational study that included data from all consecutive HIV-infected patients who attended a metabolic clinic was conducted. Included were adult, antiretroviral (ARV)-experienced, tenofovir-naive patients, whose kidney functions were evaluated by calculated GFR using the simplified Modification of Diet in Renal Disease study equation (MDRD). Tenofovir-exposed patients were patients who initiated tenofovir therapy at baseline and tenofovir-unexposed patients were patients whose ARV therapy did not include tenofovir. Participants were stratified into three sub-groups according to the plasma HIV-1 RNA (VL) changes observed: sub-groups 1, 2 and 3 were patients with stable VL 0.5 log(10) VL increases and >0.5 VL log(10) decreases, respectively. Results Ninety-nine patients were enrolled and included in the analysis. Within the tenofovir-unexposed group, GFRs remained stable (ANOVA, P = 0.94) over the follow-up period. Within the tenofovir-exposed group, mean GFR changes varied significantly by sub-group (ANOVA, P < 0.01). In particular, GFR changes in sub-group 3 (+8.4 +/- 12.4 mL/min) were different from those seen in sub-group 1 (-1.0 +/- 8.8 mL/min) (P < 0.05) and sub-group 2 (-4.6 +/- 8.8 mL/min) (P < 0.01). Conclusions Observed improvements in GFR that occurred as a consequence of highly active ARV therapy-induced viral suppression may have more than offset any potential negative effects of tenofovir on renal function.
63 (2)
374
379
Glomerular filtration rates in HIV-infected patients treated with and without tenofovir: a prospective, observational study / Guaraldi, Giovanni; Roverato, A.; Giovanardi, C.; Ravera, F.; Squillace, N.; Orlando, Gabriella; Cappelli, Gianni; Esposito, Roberto; Palella, F.. - In: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. - ISSN 0305-7453. - STAMPA. - 63 (2):(2009), pp. 374-379. [10.1093/jac/dkn499]
Guaraldi, Giovanni; Roverato, A.; Giovanardi, C.; Ravera, F.; Squillace, N.; Orlando, Gabriella; Cappelli, Gianni; Esposito, Roberto; Palella, F.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/613402
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