Premium
Tenofovir disoproxil fumarate associated nephrotoxicity: a retrospective cohort study at two referral hospitals in Namibia
Author(s) -
Kalemeera Francis,
Godman Brian,
Stergachis Andy,
Rennie Timothy
Publication year - 2021
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.5125
Subject(s) - medicine , incidence (geometry) , retrospective cohort study , renal function , cohort , tenofovir , pregnancy , nephrotoxicity , urology , human immunodeficiency virus (hiv) , kidney , immunology , physics , biology , optics , genetics
Abstract Introduction The incidence and risk factors of tenofovir disoproxil fumarate (TDF)‐related renal impairment (RI) in Namibia are unknown where TDF‐containing ART regimens are used as the first line for HIV. Methodology A retrospective cohort study among HIV‐infected patients at two intermediate hospitals. A decline in estimated glomerular filtration rate (eGFR) was significant if it was ≥25% and included a change to a lower eGFR stage. New‐onset RI was defined as an eGFR <50 mL/min/1.73m 2 . Results 10 387 patients were included: 11.4% (n = 1182) experienced the decline in eGFR. Of these, 0.6% (n = 62) migrated to eGFR stages IV and V. The incidence was 4.5 (95% CI: 4.3‐4.8) per 100 patient years. RI developed in 400 patients for an incidence rate of 2.4 (95% CI: 2.2‐2.6) cases per 100 patient years. Risk factors with effect sizes >2.0, for decline‐in‐eGFR were baseline eGFR >60 (aHR = 15.6); hyperfiltration (aHR = 5.0); and pregnancy (aHR = 2.4); while for RI, they were hyperfiltration (aHR = 4.1) and pregnancy (aHR = 29). Conclusion The incidence of decline‐in‐eGFR was higher than in other sub‐SSA countries, but not RI. A high baseline eGFR had the greatest risk for the decline, and hyperfiltration for the RI.