McLaughlin Milena M, Guerrero Aimee J, Merker Andrew
Chicago College of Pharmacy, Midwestern University, 555 31st Street, Downers Grove, IL 60515, USA.
Northwestern Memorial Hospital, 251 E Huron St, Chicago, IL 60611, USA.
Drugs Context. 2018 Mar 21;7:212519. doi: 10.7573/dic.212519. eCollection 2018.
A review of literature published regarding non-tenofovir antiretroviral agents causing renal adverse effects was conducted. The literature involving renal adverse effects and antiretroviral therapy is most robust with protease inhibitors, specifically atazanavir and indinavir, and includes reports of crystalluria, leukocyturia, nephritis, nephrolithiasis, nephropathy and urolithiasis. Several case reports describe potential nephropathy (including Fanconi syndrome) secondary to administration of abacavir, didanosine, lamivudine and stavudine. Case reports documented renal events such as acute renal failure, nephritis, proteinuria and renal stones with efavirenz administration. Regarding rilpivirine, a small increase of serum creatinine levels (SCr) was found in clinical trials; however, the clinical significance and impact on actual renal function is unknown. The integrase strand transfer inhibitors and enfuvirtide have a relatively safe renal profile, although studies have shown dolutegravir and raltegravir cause mild elevations in SCr without an impact on actual renal function. This is similar to the reaction observed with cobicistat, the pharmacokinetic enhancer frequently given with elvitegravir.
我们对已发表的关于引起肾脏不良反应的非替诺福韦抗逆转录病毒药物的文献进行了综述。涉及肾脏不良反应与抗逆转录病毒治疗的文献中，关于蛋白酶抑制剂，特别是阿扎那韦和茚地那韦的最为丰富，其中包括结晶尿、白细胞尿、肾炎、肾结石、肾病和尿路结石的报告。几例病例报告描述了服用阿巴卡韦、去羟肌苷、拉米夫定和司他夫定后继发的潜在肾病（包括范科尼综合征）。病例报告记录了服用依非韦伦后的肾脏事件，如急性肾衰竭、肾炎、蛋白尿和肾结石。关于利匹韦林，在临床试验中发现血清肌酐水平（SCr）略有升高；然而，其临床意义以及对实际肾功能的影响尚不清楚。整合酶链转移抑制剂和恩夫韦肽的肾脏安全性相对较高，尽管研究表明多替拉韦和拉替拉韦会导致SCr轻度升高，但对实际肾功能无影响。这与经常与埃替格韦联用的药代动力学增强剂考比司他所观察到的反应相似。
