Open AccessTenofovir-induced distal renal tubular acidosis: A rare cause of recurrent hypokalaemic paralysis
Author(s) -
Mahesh Dave,
Manasvin Sareen,
Anuj Goyal,
Nagaraj T Gonchikar,
Yash Shah
Publication year - 2022
Publication title -
journal of the royal college of physicians of edinburgh/the journal of the royal college of physicians of edinburgh
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.275
H-Index - 26
eISSN - 2042-8189
pISSN - 1478-2715
DOI - 10.1177/14782715221103643
Subject(s) - medicine , hypokalemia , complication , distal renal tubular acidosis , hypokalemic periodic paralysis , renal tubular acidosis , tenofovir , nephrotoxicity , metabolic acidosis , metabolic disorder , acidosis , gastroenterology , reverse transcriptase inhibitor , human immunodeficiency virus (hiv) , kidney , virology , antiretroviral therapy , viral load
Tenofovir disoproxil fumarate was the first nucleotide analogue reverse transcriptase inhibitor to be approved for treatment of human immunodeficiency virus infection. It is a relatively safe drug but can present with nephrotoxicity. We report a case of 36-year-old male who presented with acute onset flaccid paraparesis. He was a diagnosed case of acquired immunodeficiency syndrome for 9 years ago and was on tenofovir-based antiretroviral therapy for last 6 months. As the patient had normal anion gap metabolic acidosis, hypokalaemia and urine pH > 5.5, distal renal tubular acidosis (RTA) was suspected. He improved dramatically within 24 h of hospitalisation after potassium correction to regain normal power. Tenofovir-induced distal RTA presenting as hypokalaemic paralysis is a very rare complication of tenofovir; hence, we are reporting this case. In addition, we suggest regular follow-up of patients taking tenofovir with urine analysis and serum potassium to detect this complication earlier as it is reversible.