• PDF / 141,800 Bytes
• 1 Pages / 623.591 x 841.847 pts Page_size
• 89 Downloads / 133 Views

DOWNLOAD

REPORT

---

1

S

Acute renal failure: 2 case reports Two HIV positive men developed acute renal failure while receiving antiretroviral therapy, which included tenofovir* and atazanavir. A 56-year-old man, who had a creatinine level of 0.96 mg/dL and a creatinine clearance of 85 mg/min at baseline, started receiving atazanavir 300 mg/day, tenofovir 300 mg/day, ritonavir and lamivudine. Laboratory investigations revealed the following levels and values 3 months later: creatinine 1.8 mg/dL, creatinine clearance 45 mL/min, pH 7.29 UpH [sic], bicarbonate 18 mmol/L, BSE [sic] -6 mmol/L, lactic acid 0.6 mmol/L (venous blood) and 24h proteinuria 377 mg/day. Tenofovir was withdrawn, but a creatinine clearance of 45 mL/min persisted for 6 months. A 48-year-old man started receiving atazanavir 300mg/day with ritonavir, tenofovir 245 mg/day and emtricitabine as replacement for his previous protease inhibitor regimen. At baseline, he had a creatinine level of 1.10 mg/mL and a creatinine clearance of 97.5 mL/min. His creatinine level increased to 1.56 mg/mL after 2 months of therapy, and his creatinine clearance decreased to 67 mL/min. Tenofovir was withdrawn and his creatinine level and clearance normalised 4 weeks later. Author comment: The fact that there was no previous renal failure and that it occurred soon after tenofovir was introduced therefore links this drug with the onset of renal failure. . . Before tenofovir is prescribed, a clinical and analytical examination must be performed to rule out any potential situation that may trigger a worsening in renal function, particularly in cases where atazanavir is administered at the same time. * It was unclear whether the men were receiving tenofovir or tenofovir disoproxil fumarate. Vallecillo-S´anchez G, et al. Acute renal failure associated with the use of tenofovir combined with atazanavir in patients with HIV infection. Enfermedades Infecciosas Y Microbiologia Clinica 26: 316-317, No. 5, May 2008 [Spanish; summarised 801111644 from a translation.] - Spain

0114-9954/10/1208-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Reactions 28 Jun 2008 No. 1208