First Line HIV Therapy Associated with Acute Kidney Injury

HIV drug Tenofovir may carry a risk of nephrotoxicity.

A frequently prescribed medication for HIV may carry the threat of a serious adverse event related to treatment.

Tenofovir, widely used as a first line antiretroviral therapy to treat HIV, may result in acute kidney injury, according to research presented at ASN Kidney Week 2015 in San Diego, CA.

Acute kidney injury has previously been linked to the use of nephrotoxic medications, including medical imaging dyes and anti-inflammatory drugs, in addition to being associated with postoperative complications. This type of kidney damage is costly but preventable, the study noted.

The researchers conducted a retrospective analysis of the clinical characteristics and outcomes from acute kidney injuries linked to Tenofovir use in HIV patients between March 2011 and February 2015.

The study included 72 patients, which showed 36 cases of nephrotoxic acute kidney injury. Of these cases, 19 were associated with Tenofovir, with nephrotoxicity found in 7 patients without other associated factors.

Despite the drug being withdrawn in each of these incidents, 37% of patients required hemodialysis. Furthermore, 58% of patients did not completely recover kidney function, 4 patients died from sepsis complications, and 1 patient died of hemorrhagic shock.

None of the patients became dialysis dependent.

"Since Tenofovir is a first-line therapy for HIV, infectious disease specialists and clinicians should be aware of the risk of nephrotoxicity related to its use, especially in the context of other drugs and factors that could increase [acute kidney injury]," said lead researcher Teg Marcos Veiga, MD.