Renal function outcomes in patients receiving TDF-containing antiretroviral therapy: a retrospective pilot study in Namibia

Francis Kalemeera, Carla Oberholster, Innocent Segamwenge, Dan Kibuule, Ester Naikaku, M Mwangana, Brian Godman

Research output: Contribution to journalArticle

Abstract

Introduction and aims: Combination antiretroviral therapy (cART) has improved morbidity and mortality in patients with HIV across countries including countries in sub-Sahara Africa. However, cART is associated with renal impairment. The lack of pre-cART data in a recently published study limited the discussion on renal-based treatment outcomes with cART, which could have important clinical implications. Consequently, the aim of this paper is to correct this. Methods: Longitudinal retrospective study, with renal function assessed pre-cART and at various time points on cART using the Cockcroft-Gault method. The data source was the patients’ care booklets. Results: 71 patients were included. The majority were adults and female. Before cART initiation, 70.4% and 29.6% had abnormal and normal CrCl, respectively. CrCl was normalised in 24% of patients, while abnormal in the remainder. The mean (median) time to normalisation was 47.4(33.7) months, observed more in paediatric than adult patients (p =0.014). However, in paediatric patients, normalisation took longer than in adult patients. The reduction in CrCl, was observed at variable time points. 9/16 patients experienced a decline during first-line cART and 7 of these were receiving TDF. 7/16 experienced this during second-line cART and 6 were receiving TDF. Conclusion: HIV is typically the cause of renal impairment prior to cART, with TDF likely to be the cause of renal impairment during cART. Consequently, co-administration of TDF with other nephrotoxic drugs should be undertaken with caution if unavoidable. Overall, improvement in renal impairment was faster in adults.
LanguageEnglish
Pages4273-4279
Number of pages7
JournalInternational Journal of Pharmaceutical Sciences and Research
Volume9
Issue number10
DOIs
Publication statusPublished - 1 Oct 2018

Fingerprint

Namibia
Retrospective Studies
Kidney
Therapeutics
HIV
Pediatrics
Northern Africa
Pamphlets
Information Storage and Retrieval
Longitudinal Studies
Patient Care

Keywords

  • age
  • HIV
  • Namibia
  • renal function
  • TDF

Cite this

Kalemeera, Francis ; Oberholster, Carla ; Segamwenge, Innocent ; Kibuule, Dan ; Naikaku, Ester ; Mwangana, M ; Godman, Brian. / Renal function outcomes in patients receiving TDF-containing antiretroviral therapy : a retrospective pilot study in Namibia. In: International Journal of Pharmaceutical Sciences and Research. 2018 ; Vol. 9, No. 10. pp. 4273-4279.
@article{dfa0088b54c24e4f8b861c8f44f3d858,
title = "Renal function outcomes in patients receiving TDF-containing antiretroviral therapy: a retrospective pilot study in Namibia",
abstract = "Introduction and aims: Combination antiretroviral therapy (cART) has improved morbidity and mortality in patients with HIV across countries including countries in sub-Sahara Africa. However, cART is associated with renal impairment. The lack of pre-cART data in a recently published study limited the discussion on renal-based treatment outcomes with cART, which could have important clinical implications. Consequently, the aim of this paper is to correct this. Methods: Longitudinal retrospective study, with renal function assessed pre-cART and at various time points on cART using the Cockcroft-Gault method. The data source was the patients’ care booklets. Results: 71 patients were included. The majority were adults and female. Before cART initiation, 70.4{\%} and 29.6{\%} had abnormal and normal CrCl, respectively. CrCl was normalised in 24{\%} of patients, while abnormal in the remainder. The mean (median) time to normalisation was 47.4(33.7) months, observed more in paediatric than adult patients (p =0.014). However, in paediatric patients, normalisation took longer than in adult patients. The reduction in CrCl, was observed at variable time points. 9/16 patients experienced a decline during first-line cART and 7 of these were receiving TDF. 7/16 experienced this during second-line cART and 6 were receiving TDF. Conclusion: HIV is typically the cause of renal impairment prior to cART, with TDF likely to be the cause of renal impairment during cART. Consequently, co-administration of TDF with other nephrotoxic drugs should be undertaken with caution if unavoidable. Overall, improvement in renal impairment was faster in adults.",
keywords = "age, HIV, Namibia, renal function, TDF",
author = "Francis Kalemeera and Carla Oberholster and Innocent Segamwenge and Dan Kibuule and Ester Naikaku and M Mwangana and Brian Godman",
year = "2018",
month = "10",
day = "1",
doi = "10.13040/IJPSR.0975-8232.9(10).4273-79",
language = "English",
volume = "9",
pages = "4273--4279",
journal = "International Journal of Pharmaceutical Sciences and Research",
issn = "2320-5148",
number = "10",

}

Renal function outcomes in patients receiving TDF-containing antiretroviral therapy : a retrospective pilot study in Namibia. / Kalemeera, Francis; Oberholster, Carla; Segamwenge, Innocent ; Kibuule, Dan; Naikaku, Ester; Mwangana, M; Godman, Brian.

In: International Journal of Pharmaceutical Sciences and Research, Vol. 9, No. 10, 01.10.2018, p. 4273-4279.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Renal function outcomes in patients receiving TDF-containing antiretroviral therapy

T2 - International Journal of Pharmaceutical Sciences and Research

AU - Kalemeera, Francis

AU - Oberholster, Carla

AU - Segamwenge, Innocent

AU - Kibuule, Dan

AU - Naikaku, Ester

AU - Mwangana, M

AU - Godman, Brian

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Introduction and aims: Combination antiretroviral therapy (cART) has improved morbidity and mortality in patients with HIV across countries including countries in sub-Sahara Africa. However, cART is associated with renal impairment. The lack of pre-cART data in a recently published study limited the discussion on renal-based treatment outcomes with cART, which could have important clinical implications. Consequently, the aim of this paper is to correct this. Methods: Longitudinal retrospective study, with renal function assessed pre-cART and at various time points on cART using the Cockcroft-Gault method. The data source was the patients’ care booklets. Results: 71 patients were included. The majority were adults and female. Before cART initiation, 70.4% and 29.6% had abnormal and normal CrCl, respectively. CrCl was normalised in 24% of patients, while abnormal in the remainder. The mean (median) time to normalisation was 47.4(33.7) months, observed more in paediatric than adult patients (p =0.014). However, in paediatric patients, normalisation took longer than in adult patients. The reduction in CrCl, was observed at variable time points. 9/16 patients experienced a decline during first-line cART and 7 of these were receiving TDF. 7/16 experienced this during second-line cART and 6 were receiving TDF. Conclusion: HIV is typically the cause of renal impairment prior to cART, with TDF likely to be the cause of renal impairment during cART. Consequently, co-administration of TDF with other nephrotoxic drugs should be undertaken with caution if unavoidable. Overall, improvement in renal impairment was faster in adults.

AB - Introduction and aims: Combination antiretroviral therapy (cART) has improved morbidity and mortality in patients with HIV across countries including countries in sub-Sahara Africa. However, cART is associated with renal impairment. The lack of pre-cART data in a recently published study limited the discussion on renal-based treatment outcomes with cART, which could have important clinical implications. Consequently, the aim of this paper is to correct this. Methods: Longitudinal retrospective study, with renal function assessed pre-cART and at various time points on cART using the Cockcroft-Gault method. The data source was the patients’ care booklets. Results: 71 patients were included. The majority were adults and female. Before cART initiation, 70.4% and 29.6% had abnormal and normal CrCl, respectively. CrCl was normalised in 24% of patients, while abnormal in the remainder. The mean (median) time to normalisation was 47.4(33.7) months, observed more in paediatric than adult patients (p =0.014). However, in paediatric patients, normalisation took longer than in adult patients. The reduction in CrCl, was observed at variable time points. 9/16 patients experienced a decline during first-line cART and 7 of these were receiving TDF. 7/16 experienced this during second-line cART and 6 were receiving TDF. Conclusion: HIV is typically the cause of renal impairment prior to cART, with TDF likely to be the cause of renal impairment during cART. Consequently, co-administration of TDF with other nephrotoxic drugs should be undertaken with caution if unavoidable. Overall, improvement in renal impairment was faster in adults.

KW - age

KW - HIV

KW - Namibia

KW - renal function

KW - TDF

UR - http://ijpsr.com/

U2 - 10.13040/IJPSR.0975-8232.9(10).4273-79

DO - 10.13040/IJPSR.0975-8232.9(10).4273-79

M3 - Article

VL - 9

SP - 4273

EP - 4279

JO - International Journal of Pharmaceutical Sciences and Research

JF - International Journal of Pharmaceutical Sciences and Research

SN - 2320-5148

IS - 10

ER -