Effect of changing from first- to second-line antiretroviral therapy on renal function: a retrospective study based on data from a single health facility in Namibia. Issue 8 (2nd August 2016)

• Record Type: Journal Article
• Authors: Kalemeera, Francis; Mbango, Christofina; Mubita, Mwangana; Naikaku, Esther; Gaida, Razia; Godman, Brian
• Is Part Of: Expert review of anti-infective therapy. Volume 14:Issue 8(2016)
• Page Start: 777
• Page End: 783
• Publication Date: 2016-08-02
• Subjects: Namibia -- renal function -- creatinine clearance -- combination antiretroviral therapy -- drug utilisation study; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2016.1202759
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Background: 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. Methods : Retrospective longitudinal study in patients receiving cART. Results : 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 weak had a week relationship with CrCl. Conclusion : 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.