1494. Clinical risk factors of kidney tubular dysfunction in HIV-infected Thai patients treated with tenofovir disoproxil fumarate
Session: Poster Abstract Session: Global HIV
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • Poster IDSATDF_SK.pdf (248.5 kB)
  • Background:

    Tenofovir disoproxil fumarate (TDF) is one of the widely use antiretroviral drugs. TDF associates with kidney tubular dysfunction (KTD) in some patients. We studied the association between clinical risk factors and KTD in HIV-infected Thai individuals receiving TDF.

    Methods: Blood and urine samples of 65 HIV-infected Thai patients receiving TDF-containing antiviral regimens were collected during September 2012 - January 2013. The association between KTD and clinical factors were investigated. KTD was diagnosed by the presence of at least three of the following abnormalities: b2-microglobulinuria, nondiabetic glucosuria, increased fractional excretion of uric acid, increased fractional excretion of phosphate, and renal tubular acidosis. Associations between clinical risk factors and KTD were tested by univariate and multivariate logistic regression analyses.

    Results: Thirty-three (50.5%) of the patients were female. Median (IQR) age and CD4 cell counts were 43.8 (40.4-50.9) years and 554 (437-716) cells/mm3, respectively. Median duration of TDF use was 46.9 (31.5-54.1) months. KTD was diagnosed in 13 of the 65 (20%) patients. Concomitant use of protease inhibitor (PI) [odds ratio (OR) 9.02; 95% confidence interval (CI), 1.12-72.77; P = 0.039], dyslipidemia (OR 8.40; 95% CI, 1.33-53.18; P = 0.024), and body mass index (OR 0.75; 95% CI, 0.58-0.97; P = 0.030) were independent clinical predictors associated with kidney tubular dysfunction in patients receiving TDF (TFV-KTD).


    KTD in HIV-infected Thai patients is not uncommon. The concomitant use of PI, dyslipidemia and low body mass index are associated with TFV-KTD. Closed monitoring of KTD should be warranted in patients receiving TDF with these risk factors.

    Angsana Phuphuakrat, MD, PhD1, Ekawat Pasomsub, PhD2, Wasun Chantratita, PhD2, Surakameth Mahasirimongkol, MD3, Sinee Disthabanchong, MD1, Somnuek Sungkanuparph, MD1 and Sasisopin Kiertiburanakul, MD, MHS1, (1)Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, (2)Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, (3)Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand


    A. Phuphuakrat, None

    E. Pasomsub, None

    W. Chantratita, None

    S. Mahasirimongkol, None

    S. Disthabanchong, None

    S. Sungkanuparph, None

    S. Kiertiburanakul, None

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