Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
Introduction. Tenofovir treatment in HIV/AIDS patient has a possible side effect for kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1,72 m2) after patient undergo tenofovir treatment for one year. The incidence rate for rapid decline in GFR and factors affecting it...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | Indonesian |
| Published: |
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia
2019-09-01
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| Series: | Jurnal Penyakit Dalam Indonesia |
| Subjects: | |
| Online Access: | http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/334/201 |
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| Summary: | Introduction. Tenofovir treatment in HIV/AIDS patient has a possible side effect for kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1,72 m2) after patient undergo tenofovir treatment for one year. The incidence rate for rapid decline in GFR and factors affecting it are still contradictive and not assessed completely. To identify cumulative incidence and factors affecting tenofovir related nephrotoxicity.
Methods. A retrospective cohort study was conducted in HIV/AIDS outpatient clinic in Cipto Mangunkusumo Hospital. We include patients who start to take tenofovir as their medication from January 2010 until January 2015 with consecutive sampling method. Inclusion criterias are minimum one year of tenofovir treatment and baseline GFR > 60 cc/minute/1,72 m2. Subject would be excluded if there were no data for GFR evaluation after one year. Our study used secondary data, taken from patient’s medical record. Logistic regression test was used for variabels that could potentially affect rapid decline in glomerular filtration rate.
Results. 164 subjects were included for analysis and we found incidence rate for rapid decline in GFR after one year of tenofovir medication in 87 subjects (53%; 95% CI: 45-60,4%). Factors those affecting rapid decline in GFR are male gender (OR 4,0; 95% CI: 1,1-4,8), CD4 cell count below 100 cell/mm3 (OR 3,7; 95% CI: 1,7 – 8,1), weight increase > 20 % (OR 4,0; 95% CI: 1,0 – 4,8), and baseline GFR > 90 cc/min/1,72 m2 (OR 9,8; 95% CI: 2,3 – 42,1).
Conclusion. The incidence rate for rapid decline in GFR aftre one year of tenofovir medication in HIV/AIDS patients in Cipto Mangunkusumo hospital is 53%. Risk Factors that affecting nephrotoxicity are male gender, CD4 cell count below 100 cell/mm3, weight increase > 20%, and baseline GFR > 90 cc/min/1,72 m2. |
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| ISSN: | 2406-8969 2549-0621 |