Gitman Michael D, Hirschwerk David, Baskin Cindy H, Singhal Pravin C
North Shore University Hospital, Division of Nephrology and Hypertension, Manhasset, NY, USA.
Expert Opin Drug Saf. 2007 Mar;6(2):155-64. doi: 10.1517/14740338.6.2.155.
Tenofovir disoproxil fumarate is a nucleotide reverse transcriptase inhibitor with activity against both HIV and the hepatitis B virus. It has had minimal nephrotoxic effects in early clinical trials, but as clinical use has widened, case reports describing tenofovir-induced renal tubular damage, Fanconi's syndrome and diabetes insipidus have been described. The authors review the pharmacokinetics, mechanism of action and clinical uses of tenofovir disoproxil fumarate. The large clinical trials, as well as the case reports of tenofovir-induced kidney injury, are also reviewed. The potential mechanism of renal damage is discussed and recommendations for evaluation and treatment of tenofovir-induced kidney injury are given.
富马酸替诺福韦二吡呋酯是一种核苷酸逆转录酶抑制剂，对HIV和乙型肝炎病毒均有活性。在早期临床试验中，它的肾毒性作用极小，但随着临床应用范围的扩大，已出现了描述替诺福韦引起肾小管损伤、范科尼综合征和尿崩症的病例报告。作者综述了富马酸替诺福韦二吡呋酯的药代动力学、作用机制及临床应用。同时也回顾了大型临床试验以及替诺福韦所致肾损伤的病例报告。讨论了肾损伤的潜在机制，并给出了评估和治疗替诺福韦所致肾损伤的建议。
