Rapid Communication: Acute Renal Failure Associated with Tenofovir: Evidence of Drug-Induced Nephrotoxicity

doi:10.1097/00000441-200212000-00011

The American Journal of the Medical Sciences

Volume 324, Issue 6, December 2002, Pages 342-344

https://doi.org/10.1097/00000441-200212000-00011 Get rights and content

ABSTRACT

Drug-induced renal failure is a relatively common event in patients infected with HIV. This group of patients receives a number of potentially nephrotoxic medications for a variety of illnesses. The acyclic nucleoside phosphonates cidofovir and adefovir are antivirals that possess significant nephrotoxicity. Interestingly, tenofovir disoproxil fumurate (DF) is structurally similar to these 2 agents, yet seems to be less nephrotoxic based on a few published studies in HIV patients with intact renal function. We present a case in which acute renal failure developed after therapy with tenofovir DF in a patient with HIV and stable chronic kidney disease.

Section snippets

Case Report

A 44-year-old man with a history of HIV infection, mild chronic kidney disease (baseline serum creatinine, 1.8 to 2.0 mg/dL) due to multiple previous courses of amphotericin B for cryptococcal infection (1994 and 1995), hepatitis C infection, and depression with psychotic features was transferred to Yale-New Haven Hospital from Yale Psychiatric Hospital for evaluation of acute renal failure.

Approximately 10 months before admission, the CD4 count was 229 cells/mm³ and the viral load was 5400

Discussion

The patient presented in this case report is believed to have developed acute renal failure from tenofovir-induced acute tubular necrosis. Renal failure was noted to occur 6 weeks after initiation of tenofovir DF. Importantly, the patient had not received any other known nephrotoxic medications (including nonsteroidal anti-inflammatory drugs or herbal medications) and had no evidence of hypotension, volume depletion, infection, or urinary tract obstruction. The kidney biopsy demonstrated acute

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Rapid CommunicationRapid Communication: Acute Renal Failure Associated with Tenofovir: Evidence of Drug-Induced Nephrotoxicity

ABSTRACT

Section snippets

Case Report

Discussion

J Biol Chem

Tenofovir DF in antiretroviral-experienced patients: results from a 48-week, randomized, double-blind study

AIDS

Phase I/II trial of the pharmacokinetics, safety, and antiretroviral activity of tenofovir disoproxil fumarate in human immunodeficiency virus-infected adults

Antimicrob Agents Chemother

Cidofovir: a new therapy for cytomegalovirus retinitis

J Acqur Immune Defic Syndr Hum Retroviral

Clinical experience with cidofovir in the treatment of cytomegalovirus retinitis

J Acqur Immune Defic Syndr Hum Retrovirol

Parenteral cidofovir for cytomegalovirus retinitis in patients with AIDS: the HPMPC peripheral cytomegalovirus retinitis trial. A randomized, controlled trial. Studies of ocular complications of AIDS Research Group in Collaboration with the AIDS Clinical Trials Group

Ann Intern Med

Rapid Communication
Rapid Communication: Acute Renal Failure Associated with Tenofovir: Evidence of Drug-Induced Nephrotoxicity