Tenofovir clearance is reduced in HIV-positive patients with subclinical tubular impairment.

摘要: OBJECTIVE To assess if tenofovir (TFV) clearance is associated with urinary retinal-binding protein (RBP) in HIV-positive patients normal estimated filtration rate. DESIGN A cross-sectional diagnostic study. METHODS creatinine above 60 ml/min, on disoproxil fumarate (TDF)-containing combination since at least 6 months, taking TDF night, and without significant comorbidities (diabetes, untreated hypertension, known renal malformations, recurrent nephrolithiasis) nephrotoxic drugs were included. TFV plasma concentrations measured 12 h after drug intake (C12). RBP was through enzyme immunoassay kit spot urines corrected per (uRBP/uCr); normality ranges below 130 μg/g (in aged <50 years) 172 μg/g ≥50 years). RESULTS Two hundred eighty-nine included (median age of 45.8 years, 71.6% male 85.4% whites); concomitantly treated nonnucleoside reverse transcriptase inhibitors (155, 53.6%), protease (118, 40.8%), or integrase (16, 5.5%)-containing regimens. Estimated 89.4 ml/min (78.6-105.9). Urinary (uRBP) uRBP/uCr 204.6 ng/ml (92-380) 169.7 μg/g (85.8-318.3), respectively; abnormally high observed 157 (54.3%). multivariate binary logistic regression confirmed that both ethnicity (P = 0.004, β 2.93, 95% confidence interval 1.41-6.10) C12 less than 21 mg/ml (P = 0.006, 2.04, 1.12-3.41) significantly abnormal uRBP/uCr. CONCLUSION TDF-treated showed a prevalence proximal tubular impairment: (whites) low elevated uRBP. SDC VIDEO:: http://links.lww.com/QAD/A852.