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: Prima Yuriandro, Evy Yunihastuti, Maruhum Bonar H. Marbun, Pringgodigdo Nugroho
Format: Article
Language:Indonesian
Published: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia 2019-09-01
Series:Jurnal Penyakit Dalam Indonesia
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Online Access:http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/334/201
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author Prima Yuriandro
Evy Yunihastuti
Maruhum Bonar H. Marbun
Pringgodigdo Nugroho
author_facet Prima Yuriandro
Evy Yunihastuti
Maruhum Bonar H. Marbun
Pringgodigdo Nugroho
author_sort Prima Yuriandro
collection DOAJ
description 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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publisher Department of Internal Medicine, Faculty of Medicine Universitas Indonesia
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series Jurnal Penyakit Dalam Indonesia
spelling doaj-art-1cae0cdaa9df4cf1a238fffacb849fdd2025-08-20T02:23:03ZindDepartment of Internal Medicine, Faculty of Medicine Universitas IndonesiaJurnal Penyakit Dalam Indonesia2406-89692549-06212019-09-0163141149http://dx.doi.org/10.7454/jpdi.v6i3.334Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil FumaratePrima Yuriandro0Evy Yunihastuti1Maruhum Bonar H. Marbun2Pringgodigdo Nugroho3Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RSUPN dr. Cipto Mangunkusumo, Jakarta Indonesia Divisi Alergi Imunologi Klinik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RSUPN dr. Cipto Mangunkusumo, Jakarta Indonesia Divisi Ginjal Hipertensi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RSUPN dr. Cipto Mangunkusumo, Jakarta Indonesia Divisi Ginjal Hipertensi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RSUPN dr. Cipto Mangunkusumo, Jakarta Indonesia 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.http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/334/201HIV/AIDSRapid decline in GFRTenofovir
spellingShingle Prima Yuriandro
Evy Yunihastuti
Maruhum Bonar H. Marbun
Pringgodigdo Nugroho
Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
Jurnal Penyakit Dalam Indonesia
HIV/AIDS
Rapid decline in GFR
Tenofovir
title Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
title_full Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
title_fullStr Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
title_full_unstemmed Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
title_short Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate
title_sort factors affecting rapid decline in glomerular filtration rate in hiv aids patients using tenofovir disoproxil fumarate
topic HIV/AIDS
Rapid decline in GFR
Tenofovir
url http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/334/201
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