Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, 521 Parnassus Ave, C-152 Box 0622, San Francisco, CA 94143-0622, USA.
J Natl Med Assoc. 2011 Jun;103(6):518-22. doi: 10.1016/s0027-9684(15)30367-9.
The effects of tenofovir on renal function have been measured in multiple studies. Although African Americans are at a higher risk of developing chronic kidney disease, there are limited data examining the influence of race on tenofovir-related nephrotoxicity.
This was a retrospective study of human immunodeficiency virus (HIV)-infected patients at a university-affiliated HIV clinic who were prescribed tenofovir between July 1, 2001, and January 31, 2009. The primary outcome was mean change in creatinine clearance. Secondary endpoints assessed the odds of tenofovir discontinuation secondary to nephrotoxicity, and prevalence of grade 2 to 4 serum creatinine elevation and hypophosphatemia during treatment.
A total of 65 African American and 186 Caucasian patients were included. There were no statistically significant differences in mean change in creatinine clearance, as estimated by the Cockcroft-Gault (-14.2 mL/min vs -15.9 mL/min [P = .525]) and modification of diet in renal disease formulas (-17.2 mL/min/1.73 m2 vs -15.6 mL/min/1.73 m2 [P = .585]) between African Americans and Caucasians. Rates of tenofovir discontinuation secondary to nephrotoxicity were 6.2% and 1.6%, respectively (P = .076). Elevated baseline serum creatinine and female gender may be potential predictors for tenofovir discontinuation.
There were no statistically significant differences in tenofovir-related renal function changes by race as observed in our HIV patient population.
已有多项研究检测了替诺福韦对肾功能的影响。尽管非裔美国人患慢性肾病的风险更高，但关于种族对替诺福韦相关肾毒性影响的数据有限。
这是一项回顾性研究，纳入了 2001 年 7 月 1 日至 2009 年 1 月 31 日期间在一所大学附属医院的艾滋病病毒（HIV）诊所就诊、开处了替诺福韦的 HIV 感染者。主要结局为肌酐清除率的平均变化。次要终点评估了因肾毒性而停用替诺福韦的几率，以及治疗期间出现 2 至 4 级血清肌酐升高和低磷血症的患病率。
共纳入 65 名非裔美国人和 186 名白种人。非裔美国人组和白种人组的肌酐清除率平均变化（通过 Cockcroft-Gault 公式估计为-14.2 mL/min 与-15.9 mL/min[P=.525]，通过改良肾脏病饮食公式估计为-17.2 mL/min/1.73 m2 与-15.6 mL/min/1.73 m2[P=.585]）无统计学差异。因肾毒性而停用替诺福韦的几率分别为 6.2%和 1.6%（P=.076）。基线时血清肌酐升高和女性可能是停用替诺福韦的潜在预测因素。
在我们的 HIV 患者人群中，种族对替诺福韦相关肾功能变化无统计学差异。
