Tenofovir Nephrotoxicity: 2011 Update

被引:217
作者
Fernandez-Fernandez, Beatriz [1 ]
Montoya-Ferrer, Ana [2 ]
Sanz, Ana B. [3 ]
Sanchez-Nino, Maria D. [3 ]
Izquierdo, Maria C. [1 ]
Poveda, Jonay [1 ]
Sainz-Prestel, Valeria [1 ]
Ortiz-Martin, Natalia [1 ]
Parra-Rodriguez, Alejandro [1 ]
Selgas, Rafael [3 ]
Ruiz-Ortega, Marta [1 ]
Egido, Jesus [1 ]
Ortiz, Alberto [1 ,4 ]
机构
[1] Univ Autonoma Madrid, FRIAT, IRSIN, IIS Fdn Jimenez Diaz,Nefrol, Madrid, Spain
[2] IIS Fdn Jimenez Diaz, Med Interna, Madrid, Spain
[3] Univ Autonoma Madrid, FRIAT, IRSIN, IDiPaz,Nefrol, Madrid, Spain
[4] Fdn Jimenez Diaz, Unidad Dialisis, Madrid 28040, Spain
关键词
D O I
10.1155/2011/354908
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Tenofovir is an acyclic nucleotide analogue reverse-transcriptase inhibitor structurally similar to the nephrotoxic drugs adefovir and cidofovir. Tenofovir is widely used to treat HIV infection and approved for treatment of hepatitis B virus. Despite initial cell culture and clinical trials results supporting the renal safety of tenofovir, its clinical use is associated with a low, albeit significant, risk of kidney injury. Proximal tubular cell secretion of tenofovir explains the accumulation of the drug in these mitochondriarich cells. Tenofovir nephrotoxicity is characterized by proximal tubular cell dysfunction that may be associated with acute kidney injury or chronic kidney disease. Withdrawal of the drug leads to improvement of analytical parameters that may be partial. Understanding the risk factors for nephrotoxicity and regular monitoring of proximal tubular dysfunction and serumcreatinine in high-risk patients is required tominimize nephrotoxicity. Newer, structurally similarmolecular derivatives that do not accumulate in proximal tubules are under study.
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页数:11
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