Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of baseline renal function on tenofovir-containing antiretroviral therapy outcomes in Zambia
Clinical Infectious Diseases, Volume 58, No. 10, Year 2014
Notification
URL copied to clipboard!
Description
Background.Although tenofovir disoproxil fumarate (TDF) use has increased as part of first-line antiretroviral therapy (ART) across sub-Saharan Africa, renal outcomes among patients receiving TDF remain poorly understood. We assessed changes in renal function and mortality in patients starting TDF-or non-TDF-containing ART in Lusaka, Zambia. Methods.We included patients aged ≥16 years who started ART from 2007 onward, with documented baseline weight and serum creatinine. Renal dysfunction was categorized as mild (estimated glomerular filtration rate [eGFR], 60-89 mL/min), moderate (30-59 mL/min), or severe (<30 mL/min) according to the chronic kidney disease-epidemiology (CKD-EPI) formula. Differences in eGFR during ART were analyzed using linear mixed-effect models. The odds of developing moderate or severe eGFR decrease and mortality were assessed using logistic and competing risk regression, respectively. Results.We included 62 230 adults, of which 38 716 (62.2%) initiated a TDF-based regimen. The proportion with moderate or severe renal dysfunction at baseline was lower in the TDF than in the non-TDF group (1.9% vs 4.0%). Among patients with no or mild renal dysfunction, those receiving TDF were more likely to develop moderate (adjusted odds ratio, 3.11; 95% confidence interval, 2.52-3.87) or severe (2.43; 1.80-3.28) eGFR decrease, although the incidence in such episodes was low. Among patients with moderate or severe renal dysfunction at baseline, renal function improved independently of ART regimen, and mortality rates were similar in both treatment groups. Conclusions.TDF use did not attenuate renal function recovery or increase the mortality rate in patients with renal dysfunction. Further studies are needed to determine the role of routine renal function monitoring before and during ART use in Africa. © 2014 The Author.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4001288/bin/supp_58_10_1473__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC4001288/bin/supp_ciu117_ciu117supp.pdf
Authors & Co-Authors
Mulenga, Lloyd Berdad
Zambia, Lusaka
Centre for Infectious Disease Research
Switzerland, Bern
University of Bern
Zambia, Lusaka
University of Zambia
Musonda, Patrick
Zambia, Lusaka
Centre for Infectious Disease Research
United Kingdom, Norwich
University of East Anglia, Norwich Medical School
Mwango, Albert J.
Zambia, Lusaka
Zambian Ministry of Health
Vinikoor, Michael J.
Zambia, Lusaka
Centre for Infectious Disease Research
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Davies, M. A.
South Africa, Cape Town
University of Cape Town
Mweemba, Aggrey
Switzerland, Bern
University of Bern
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Stringer, Jeffrey S.A.
Zambia, Lusaka
Centre for Infectious Disease Research
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Keiser, Olivia
Switzerland, Bern
University of Bern
Chi, Benjamin H.
Zambia, Lusaka
Centre for Infectious Disease Research
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Wandeler, Gilles
Switzerland, Bern
University of Bern
Switzerland, Bern
University Hospital Bern
Senegal, Dakar
Université Cheikh Anta Diop de Dakar
Statistics
Citations: 65
Authors: 11
Affiliations: 10
Identifiers
Doi:
10.1093/cid/ciu117
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Noncommunicable Diseases
Study Design
Cohort Study
Case-Control Study
Study Locations
Zambia