Risk Factor for Nephrotoxicity in Patients Receiving Tenofovir Disoproxil Fumarate in a Super Tertiary Hospital

Abstract

Background: Tenofovir disoproxil fumarate (TDF) is the first line agent in the treatment regimen for patients infected with human immunodeficiency virus and/or chronic hepatitis B virus. It has good efficacy with low resistance, and is administered once daily administration. However, the drug may cause nephrotoxicity. Therefore, information of the risk factors associated with nephrotoxicity induced by TDF may be useful in the planning for prevention or monitoring patient who may develop drug induced nephrotoxicity.

Objectives: To investigate for the risk factors associated with nephrotoxicity from TDF.

Method: The retrospective cohort study of patients receiving TDF at Srinagarind hospital, a super tertiary hospital, was conducted. Data including patients’ characteristics, medications and laboratory investigations during 2018-2020 were collected from electronic database. Nephrotoxicity was assessed from the occurrence of impaired kidney function or Fanconi’s syndrome. Logistic regression was used for analysis of risk factors associated with drug induced nephrotoxicity.

Results: There were 320 patients in this study. The average age was 43.5 + 12.6 years. Most of them were male (62.5%), had HIV-infection (78.4%) and used TDF longer than 2 years (84.7%). Nephrotoxicity was found in 26 patients (8.1%) and risk factors associated with nephrotoxicity were age > 50 years and protease inhibitor use.

Conclusion: The incidence of nephrotoxicity after TDF was low and 2 risk factors were associated with nephrotoxicity. Therefore, patients with age > 50 years and protease inhibitor use should be surveillance and closely monitored.