Tenofovir Induced Acute Kidney Injury in HIV Infected Patient

Main Article Content

Bhawna Agnani
Deepika Hemrajani
Ranjana Solanki

Abstract

Tenofovir is an antiretroviral drug used in combination with other antiretroviral agents. It is an effective therapy for HIV infection. Kidney injury induced by this drug has been known to occur in the HIV positive patients. When given in titrated doses, it is safe and should be combined with regular monitoring of renal function and serum phosphate levels. We present a case report of Tenofovir induced nephropathy in a patient diagnosed to have acquired immunodeficiency syndrome 8 years ago and was on TDF based anti‑retroviral therapy. The patient had normal serum creatinine, normal blood glucose levels, raised serum bilirubin and amylase levels, mild anemia with glycosuria and proteinuria. Renal biopsy revealed normal glomeruli with dilated proximal tubules and attenuation of brush border. Our case reverted back to normal upon withdrawal of drug.  We present this case to emphasize that the clinician should be aware of TDF induced acute kidney injury (AKI) presentation.

Keywords:
Tenofovir, retroviral disease, acute toxic tubular injury.

Article Details

How to Cite
Agnani, B., Hemrajani, D., & Solanki, R. (2021). Tenofovir Induced Acute Kidney Injury in HIV Infected Patient. Asian Journal of Research in Nephrology, 4(1), 32-35. Retrieved from http://journalajrn.com/index.php/AJRN/article/view/30113
Section
Case Report

References

Schooley RT, Ruane P, Myers RA, Beall G, Lampiris H, et al. Tenofovir DF in antiretroviral-experienced patients: results from a 48-week, randomized, double-blind study. AIDS. 2002;16: 1257-1263.

Nelson MR, Katlama C, Montaner JS, Cooper DA, Gazzard B, et al. The safety of tenofovir disoproxil fumarate for the treatment of HIV infection in adults: The first 4 years. AIDS. 2007;21:1273-1281.

Gallant JE, Staszewski S, Pozniak AL, DeJesus E, Suleiman JM, et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. Journal of the American Medical Association. 2004;292:191-201.

Verhelst D, Monge M, Meynard JL, Fouqueray B, Mougenot B, Girard PM, ET AL. Fanconi syndrome and renal failure induced by tenofovir: A first case report. Am J Kidney Dis 40:1331–1333, 2002pmid:12460055

Beatriz FF, Montoya Ferrer A, Sanz AB, Sanchez-Niño MD, Izquierdo MC, et al. TenofovirNephrotoxicity: Update. AIDS Research and Treatment; 2011.

Murali MK, Subbalaxmi MV, Megha Uppin, Radhika S. Delayed onset renal failure in a patient on tenofovir based antiretroviral regimen. Indian J Pharmacol. 2014;46: 230-231.

Herlitz LC, Mohan S, Stokes MB, Radhakrishnan J, D’Agati VD, et al. Tenofovir nephrotoxicity:Acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities. Kidney Int. 2010;78:1171-1177.