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HIV Therapies and the Kidney: Some Good, Some Not So Good?

  • Antiretroviral Therapies (A Pozniak, Section Editor)
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Abstract

Several observational studies have identified tenofovir as an independent risk factor for kidney impairment. Conversely, randomized trials have only demonstrated minor tenofovir-related changes in kidney function, but these studies included patients with normal kidney function and with low underling risk for progression of their renal function, had limited size, and limited follow-up. Several potential mechanisms of tenofovir nephrotoxicity are known. Atazanavir can, equally to indinavir, cause urolithiasis, but both drugs have also been associated with chronic kidney disease (CKD) and fast declining eGFR in persons without clinical symptoms of urolithiasis, especially when the plasma drug concentration is boosted by concomitant ritonavir use. In 2012, only a minority of HIV-positive individuals are affected by drug-induced nephrotoxicity. However, in the future, the clinical impact and hence the requirement for more research in this area will likely increase due to ageing and continued cART exposure of the HIV-positive population.

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Disclosure

L. Ryom: none; A. Mocroft: consultant to/honoraria from BMS, Gilead, BI, Merck, and Pfizer; J. Lundgren: none.

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  1. Copenhagen HIV Programme, University of Copenhagen, Faculty of Health Sciences, The Panum Institute/Building 21.1. Blegdamsvej 3B, 2200, Copenhagen N, Denmark

    Lene Ryom & Jens Lundgren

  2. HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, Division of Population Health, University College London Medical School, Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK

    Amanda Mocroft

  3. Department of Infectious Disease, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Section 5132, 2100, Copenhagen Ø, Denmark

    Jens Lundgren

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Correspondence to Lene Ryom.

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Ryom, L., Mocroft, A. & Lundgren, J. HIV Therapies and the Kidney: Some Good, Some Not So Good?. Curr HIV/AIDS Rep 9, 111–120 (2012). https://doi.org/10.1007/s11904-012-0110-3

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