Effect of changing from first- to second- line antiretroviral therapy on renal function: a retrospective study based on data from a single health facility in Namibia

Francis Kalemeera, Christofina Mbango, Mwangana Mubita, Esther Naikaku, Razia Gaida, Brian Godman

Research output: Contribution to journalArticle

Abstract

Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. Objective: Assess effects of second-line cART on renal function. Methods: Retrospective longitudinal study in patients receiving cART. Results: 71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/ EFV. Before second-line cART, 46.5% had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART; time spent on cART weak relationship with CrCl. Conclusion: Patients on first-line cART for several years without renal impairment may experience new onset impairment during cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.
LanguageEnglish
JournalExpert Review of Anti-infective Therapy
Publication statusAccepted/In press - 14 Jun 2016

Fingerprint

Namibia
Health Facilities
Retrospective Studies
Kidney
Tenofovir
Creatinine
Therapeutics
Lamivudine
Lopinavir
Stavudine
Ritonavir
Zidovudine
Longitudinal Studies

Keywords

  • Namibia
  • renal function
  • creatinine clearance
  • combination antiretroviral therapy
  • drug utilisation study

Cite this

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title = "Effect of changing from first- to second- line antiretroviral therapy on renal function: a retrospective study based on data from a single health facility in Namibia",
abstract = "Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. Objective: Assess effects of second-line cART on renal function. Methods: Retrospective longitudinal study in patients receiving cART. Results: 71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/ EFV. Before second-line cART, 46.5{\%} had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART; time spent on cART weak relationship with CrCl. Conclusion: Patients on first-line cART for several years without renal impairment may experience new onset impairment during cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.",
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Effect of changing from first- to second- line antiretroviral therapy on renal function : a retrospective study based on data from a single health facility in Namibia. / Kalemeera, Francis; Mbango, Christofina ; Mubita, Mwangana; Naikaku, Esther; Gaida, Razia; Godman, Brian.

In: Expert Review of Anti-infective Therapy, 14.06.2016.

Research output: Contribution to journalArticle

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AU - Kalemeera, Francis

AU - Mbango, Christofina

AU - Mubita, Mwangana

AU - Naikaku, Esther

AU - Gaida, Razia

AU - Godman, Brian

PY - 2016/6/14

Y1 - 2016/6/14

N2 - Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. Objective: Assess effects of second-line cART on renal function. Methods: Retrospective longitudinal study in patients receiving cART. Results: 71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/ EFV. Before second-line cART, 46.5% had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART; time spent on cART weak relationship with CrCl. Conclusion: Patients on first-line cART for several years without renal impairment may experience new onset impairment during cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.

AB - Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. Objective: Assess effects of second-line cART on renal function. Methods: Retrospective longitudinal study in patients receiving cART. Results: 71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/ EFV. Before second-line cART, 46.5% had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART; time spent on cART weak relationship with CrCl. Conclusion: Patients on first-line cART for several years without renal impairment may experience new onset impairment during cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.

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