Abstract:
ABSTRACT
Background: The use of tenofovir disoproxil fumarate (TDF) has been reported to be a
significant contributor to renal dysfunction However, there is no adequate data on its effect
on renal function in Ethiopia.
Objective: tenofovir disoproxil fumarate renal dysfunction among adult HIV patients at the
University of Gondar comprehensive specialized hospital, Northwest Ethiopia.
Methods: A retrospective cohort study was conducted at the University of Gondar
Comprehensive Specialized Hospital, Northwest Ethiopia. Patients who started TDF and
non-TDF based regimen between January 2015 and June 2019 were included in this study.
The estimated glomerular filtration rate (eGFR) was estimated by Chronic Kidney Disease
Epidemiology(CKD-EPI) equation. Renal dysfunction was defined as GFR <60 mL/min/1.73
m
2
decrease of baseline eGFR. Data were collected from the patient charts. It was entered
into EpiInfo
TM
7 software. Then it was transformed into SPSS® software version 20 and
analyzed. The descriptive statistics were summarized by using mean, frequency, and
proportion. Baseline characteristics of the TDF and non-TDF groups were compared by Chisquare.
The Kaplan–Meier method was used to estimate the survival curves. Cox's
proportional hazards models were used to identify predictors of renal dysfunction using a
95% confidence interval and p-value ? 0.05 as a statistical significance.
Result: Out of 400 participants, 200 were TDF -based ART group and 200 were non- TDF
based ART groups. The incidence of renal dysfunction of TDF and non-TDF group was
28.31 per 100 person-years (PYs) and 12.53 per 100 PYs, respectively. The use of TDF
based regimen associated with renal dysfunction around 2 (AHR = 1.696; 95% CI = 1.0212.817;
p
=0.041)
times
at
higher
risk
of
renal
dysfunction
than
non-TDF
based
regimen.
Age
?55,
diabetes mellitus, concurrent nephrotoxic drug use, and combined use of ritonavirboosted
protease
inhibitors
were
also
associate
significantly
with renal
dysfunction.
Conclusion:
The incidence rate of renal dysfunction among TDF users is higher than non-
TDF users. Exposure to TDF is a significant risk of renal dysfunction in HIV-infected adult
patients. All concerned bodies should regularly monitor the renal function of HIV patients
who are taking TDF.
Keywords: - Antiretroviral therapy, renal dysfunction, tenofovir disoproxil fumarate,
Estimated Glomerular filtration rate, Gondar, Ethiopia
