a School of Pharmacy, Faculty of Health Sciences , University of Namibia , Windhoek , Namibia.
b Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
Expert Rev Anti Infect Ther. 2016 Aug;14(8):777-83. doi: 10.1080/14787210.2016.1202759. Epub 2016 Jul 14.
Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. As a result, the aim of this study is to assess effects of second-line cART on renal function.
Retrospective longitudinal study in patients receiving cART.
71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/EFV. Before second-line cART, 46.5% had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART. Time spent on cART had a weak relationship with CrCl.
Patients on first-line cART for several years without renal impairment may experience new onset impairment during second line cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.
富马酸替诺福韦二吡呋酯（TDF）和洛匹那韦/利托那韦（LPV/r）联合用于二线抗逆转录病毒治疗（cART）时可能会导致肾功能损害，从而增加肾毒性风险。因此，本研究旨在评估二线 cART 对肾功能的影响。
对接受 cART 的患者进行回顾性纵向研究。
71 例患者接受 TDF、齐多夫定或司他夫定，分别与 3TC/NVP 或 3TC/EFV 联合使用。在二线 cART 之前，46.5%的患者肾功能异常。一线 cART 与估算的肌酐清除率（CrCl）无关。在二线 cART 期间，与女性相比，更多的男性出现肾功能异常，更多的女性 CrCl 增加。二线 cART 期间的估算 CrCl 与一线 cART 期间的 CrCl 密切相关。接受 cART 的时间与 CrCl 呈弱相关。
在一线 cART 治疗数年且无肾功能损害的患者，在二线 cART 期间可能会出现新的肾功能损害。在切换至二线 cART 之前就存在肾功能损害的患者可能会进一步恶化。
