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Because protease inhibitors (PIs) might reduce renal clearance of tenofovir, concerns have been raised that this drug combination may be more likely to cause kidney damage than the combination of tenofovir with efavirenz. To test this hypothesis, investigators in Italy evaluated changes in renal function among 91 treatment-naive patients who were randomized to receive tenofovir/FTC plus either ritonavir-boosted atazanavir or efavirenz.
Glomerular filtration rate (GFR) was estimated using two different Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations — one with creatinine and one with cystatin C (a protein that is cleared by glomerular filtration and is less influenced by muscle mass than creatinine).
During the 48-week st…