Understanding Tenofovir-Associated Renal Toxicity

Tenofovir use has been associated with the development of renal dysfunction. Some reports suggest that when the drug is discontinued, renal function normalizes, but others indicate that the damage may be irreversible. To explore this issue further, investigators reviewed data from 24 HIV-infected men who received tenofovir and then discontinued it because their estimated glomerular filtration rates (eGFRs) fell to below 60 mL/minute/1.73 m². All but one of the study participants were white, and 79% had received a protease inhibitor (PI) concurrently with tenofovir.

During tenofovir treatment (median, 30 months), the median eGFR fell from 74 to 51 mL/minute/1.73 m², representing a monthly decline of 1.2 mL/minute/1.73 m². After tenofovir was …