Nephrotoxicity as a Complication of Antiretroviral Therapy

Valle, Ramsis; Haragsim, Lukas

doi:10.1053/j.ackd.2006.04.011

Cited by 33 publications

(15 citation statements)

References 26 publications

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“…This can be explained by prolonged survival due to improved treatment, resulting in increased long-term complications from the underlying disease [20,24]. Kidney disease can be caused directly through HIV, opportunistic infections, or drug-related effects [20].…”

Section: Introductionmentioning

confidence: 98%

“…Although these medications are effective, they may have unknown sideeffect profiles that are discovered only during postmarketing surveillance. Acute renal failure induced by antiretroviral therapy has been described for zidovudine, delavirdine (rhabdomyolysis with myoglobinuria), tenofovir, ritonavir (direct tubular toxicity), and indinavir (crystal NP, acute interstitial nephritis) [20,23,24]. Atazanavir is a new protease inhibitor that shows a high specificity for HIV-1 protease.…”

Section: Introductionmentioning

confidence: 98%

“…Kidney disease can be caused directly through HIV, opportunistic infections, or drug-related effects [20]. Acute renal failure in HIV infection overall is rare but may be caused by the toxic effects of antiretroviral therapy or nephrotoxic antimicrobial substances used in the treatment of opportunistic infections [2,24]. Chronic renal disease can be caused by multiple pathophysiological mechanisms, leading to HIV-associated nephropathy (NP), a form of collapsing focal glomerulosclerosis, thrombotic microangiopathy, and various forms of immune complex glomerulonephritis (GN) [20].…”

Section: Introductionmentioning

confidence: 99%

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Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

et al. 2007

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We performed a retrospective analysis on kidney biopsies of 30 human immunodeficiency virus (HIV)-positive patients. Twenty-two of them received highly active antiretroviral therapy (HAART). Tenofovir containing HAART together with atazanavir, a new protease inhibitor, was administered to three patients. All of them developed acute renal failure. The kidney biopsies of these patients showed an acute interstitial nephritis or a chronic interstitial nephritis with an acute component. Withdrawal of atazanavir and tenofovir resulted in recovery of renal function in all three patients. Acute interstitial nephritis was observed only in 1 of 19 patients without atazanavir or tenofovir treatment. We conclude that acute interstitial nephritis and consecutive acute renal failure is a relevant side effect of atazanavir and tenofovir therapy in HIV-positive patients.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

et al. 2007

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“…32 However, saquinavir has been shown to be a safe antiretroviral drug from the point of view of nephrotoxicity, so the risk of CKD of the saquinavir/ritonavir combination observed in our population is probably due to ritonavir. 33 Regarding the weaknesses of our work, the retrospective nature of the study stands out with all the limitations that this entails for obtaining clinical, laboratory, and antiretroviral treatment information. It was not possible to assess the effect of coinfection with HBV and HCV in the logistic regression model due to the small number of patients coinfected with these viruses in our population.…”

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confidence: 99%

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

et al. 2019

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Fatores epidemiológicos, clínicos e laboratoriais associados à doença renal crônica em pacientes mexicanos infectados pelo HIV Objetivo: Determinar a prevalência de doença renal crônica (DRC) e os fatores epidemiológicos, clínicos e laboratoriais associados à DRC em pacientes mexicanos infectados pelo HIV. Métodos: Estudo transversal. Incluímos 274 pacientes com HIV/AIDS. A DRC foi definida pela taxa de filtração glomerular estimada (TFGe < 60 mL/min/1,73 m 2 , avaliada pelo CKD-EPI) e pelos critérios de albuminúria das diretrizes do KDIGO. As características clínicas, epidemiológicas e laboratoriais foram comparadas entre pacientes com e sem DRC. Os fatores associados à DRC foram avaliados por análise de regressão logística. Resultados: A média da idade foi de 41 ± 11 anos e 72,3% dos pacientes eram homens. A prevalência global de DRC foi de 11,7% (n = 32); 7,2% (n = 20) foram definidos pelo critério TFGe; 7,6% (n = 21), pelo critério da albuminú-ria; e 3,2% (n = 9), pelos dois critérios para DRC. Os estágios mais frequentemente observados da DRC foram o estágio KDIGO G3A1 com 4,7% (n = 13); estágio KDIGO G1A2 com 3,6% (n = 10) e estágio KDIGO G3A2 com 1,7% (n = 5). Os fatores associados à DRC foram o uso de abacavir/lamivudina (OR 3,2; IC95% 1,1-8,9; p = 0,03), contagem de linfócitos CD4 < 400 células/ μL (OR 2,6; 95% 1,03-6,4, p = 0,04), idade (OR 1,1; IC95% 1,04-1,2, p = 0,001) e albuminúria (OR 19,98; IC95%: 5,5-72,2; p < 0,001). Conclusões: A DRC foi uma complicação frequente em pacientes infectados pelo HIV. Esses achados confirmam a importância do rastreamento e da detecção precoce da DRC, bem como a importância de identificar e tratar os fatores de risco tradicionais e não tradicionais associados à DRC. ResumoPalavras-chave: Insuficiência Renal Crôni-ca; HIV; Insuficiência Renal. Aim:To determine the prevalence of chronic kidney disease (CKD) and the epidemiological, clinical, and laboratory factors associated with CKD in Mexican HIV-infected patients. Methods: Crosssectional study. We included 274 patients with HIV/AIDS. CKD was defined by the estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m 2 assessed by CKD-EPI) and albuminuria criteria from KDIGO guidelines. Clinical, epidemiological, and laboratory characteristics were compared between patients with and without CKD. The factors associated with CKD were assessed by logistic regression analysis. Results: The mean age was 41±11 years, and 72.3% of the patients were men. The global prevalence of CKD was 11.7% (n = 32); 7.2% (n = 20) were defined by eGFR criterion; 7.6% (n = 21), by the albuminuria criterion; and 3.2% (n = 9), by both CKD criteria. The most frequently observed stages of CKD were KDIGO G3A1 stage with 4.7% (n = 13), KDIGO G1A2 stage with 3.6% (n = 10) and KDIGO G3A2 stage with 1.7% (n = 5). The factors associated with CKD were use of abacavir/lamivudine (OR 3.2; 95% CI 1.1-8.9; p = 0.03), a CD4 lymphocyte count < 400 cells/μL (OR 2.6; 95% 1.03-6.4, p = 0.04), age (OR 1.1; 95% CI 1.04-1.2, p = 0.001) and albuminuria (OR 19.98...

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“…Introdução ___________________________________________________________________________ Devido ao fato da terapia medicamentosa não ser capaz de erradicar a infecção pelo HIV (FINZI et al, 1999), torna-se necessário seu uso prolongado para o controle da multiplicação viral. Como conseqüência da exposição prolongada aos anti-retrovirais, diversos efeitos colaterais têm sido descritos (NUESCH et al, 2006;VALLE;HARAGSIM, 2006) e, dentre eles, a síndrome da lipodistrofia -SL (CARR et al, 1998a;SHAW;McLEAN;EVANS, 1998;VIRABEN;AQUILINA, 1998).…”

Section: A Síndrome Da Lipodistrofiaunclassified

Polimorfismo da interleucina-18 e do interferon gama na síndrome da lipodistrofia associada à terapia anti-retroviral em portadores do HIV-1

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Nephrotoxicity as a Complication of Antiretroviral Therapy

Cited by 33 publications

References 26 publications

Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

Polimorfismo da interleucina-18 e do interferon gama na síndrome da lipodistrofia associada à terapia anti-retroviral em portadores do HIV-1

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