Hospital Carlos III, Pharmacokinetic & Pharmacogenetic Unit, Department of Infectious Diseases, Calle Sinesio Delgado 10, Madrid 28029, Spain.
Expert Opin Drug Saf. 2010 Jul;9(4):545-59. doi: 10.1517/14740331003627458.
Tenofovir (TFV) is a nucleotide analogue widely used for the treatment of HIV infection. Despite its proven efficacy and safety, cases of kidney tubular dysfunction have increasingly been reported and concern exists about the risk of nephrotoxicity associated with the long-term use of TFV.
Evidences about the renal toxicity associated with TFV use as well as predictors are examined. The most relevant publications assessing TFV safety and those which have reported cases of tubular dysfunction were identified and carefully revised.
Renal damage of clinical significance caused by TFV is uncommon in the short-mid-term. It occurs more frequently in subjects with underlying kidney conditions. TFV primarily results in kidney tubular dysfunction and less frequently in glomerular abnormalities. Kidney damage may progress over time under long-term TFV exposure but is reversible in most cases on drug discontinuation.
Severe renal damage associated with TFV use is uncommon and of multifactorial origin. However, mild tubular dysfunction is recognized in a substantial proportion of TFV-treated individuals and tends to increase with cumulative exposure.
替诺福韦（TFV）是一种广泛用于治疗 HIV 感染的核苷酸类似物。尽管已证明其疗效和安全性，但越来越多的情况下肾小管功能障碍的报告，并存在与长期使用 TFV 相关的肾毒性风险的担忧。
检查与 TFV 使用相关的肾毒性以及预测因子。确定并仔细审查了评估 TFV 安全性的最相关出版物，以及报告肾小管功能障碍病例的出版物。
TFV 在短中期引起的有临床意义的肾损伤并不常见。在有潜在肾脏疾病的患者中更常见。TFV 主要导致肾小管功能障碍，较少导致肾小球异常。在长期 TFV 暴露下，肾损伤可能会随着时间的推移而进展，但在大多数情况下停药后是可逆的。
与 TFV 使用相关的严重肾损伤并不常见，且具有多因素的起源。然而，在相当一部分接受 TFV 治疗的个体中已识别出轻度肾小管功能障碍，并且随着累积暴露量的增加而趋于增加。
