Tenofovir nephropathy in a patient with human immunodeficiency virus

Wei Shan Tsai, Lih Shinn Wang, Yung Hsiang Hsu, Yu Li Lin, Te Chao Fang, Bang Gee Hsu

Research output: Contribution to journalArticle

Abstract

Tenofovir is an effective and widely used antiretroviral drug for the treatment of both human immunodeficiency virus (HIV) and hepatitis B virus infection. Although large clinical studies and postmarketing data support a benign renal profile for tenofovir, numerous cases of kidney injury have raised concerns about its nephrotoxic potential. Here, we describe the case of a 33-year-old man with HIV who was treated with tenofovir, following which he developed acute renal failure with proteinuria, glucosuria, hypouricemia, hypophosphatemia, and normal anion gap metabolic acidosis, which are suggestive of acute kidney injury with Fanconi's syndrome. A renal biopsy revealed acute tubular necrosis with eosinophilic intracytoplasmic inclusions within the proximal tubular cells. Electron microscopic images demonstrate giant mitochondria and display prominent clumping, loss, and disorientation of cristae. After the discontinuation of tenofovir treatment, the patient's renal function improved and the serum uric acid and phosphorous levels returned to normal. Tenofovir-induced Fanconi's syndrome is an adverse effect that should be considered when prescribing antiretroviral therapy.

Original languageEnglish
Pages (from-to)83-86
Number of pages4
JournalTzu Chi Medical Journal
Volume27
Issue number2
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Keywords

  • Acute renal failure
  • Fanconi's syndrome
  • Human immunodeficiency virus
  • Tenofovir

ASJC Scopus subject areas

  • Medicine(all)

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