Abstract

Tenofovir Disoproxil Fumarate a nucleotide reverse transcriptase inhibitor that was introduced as a preferred first line antiretroviral therapy in Ethiopia as of 2008. However, routine renal function assessment is recommended as it is known to cause renal failure and renal tubular dysfunction.

To assess the practice of renal function monitoring of patients on TDF based ART regimen. The magnitude of renal dysfunction and its associated factors are also assessed. Institutional based retrospective record review was carried out to determine the magnitude of renal dysfunction and associated factors among HIV positive individuals who have been on TDF based ART regimen in Gondar university hospital. A total of 406 records were reviewed and 96.21% were found complete. From a total of 290 patients with Creatinine determination, renal dysfunction was found in 25.2%. Patients aged between 30-41years had AOR of 2.75(95%CI 1.18, 6.37), while those aged 42-53 years had AOR of 3.10 (95%CI 1.12, 8.55) as compared to those aged less than 30 years. Low body mass index (AOR 4.39(95%CI 2.24, 8.61), low CD4 (AOR 5.87(95%CI 2.73, 12.62)) were associated with increased risk of renal dysfunction. However Advanced WHO stages (stages 3 and 4), were associated with a lower incidence of renal dysfunction. About one fourth of patients who were on TDF regimen developed renal dysfunction. Twenty nine percent of participants had no renal function monitoring. Factors which influence the renal dysfunction in patients with TDF regimen in this study are age, low body mass index, low CD4 count and advanced WHO stage.

Key words: Renal dysfunction, Tenofovir, antiretroviral therapy (ART) regimen, Gondar University Hospital

Abbreviation

AIDS, Acquired immunodeficiency syndrome; ART, anti-retroviral therapy; ARV, antiretroviral; BMI, body mass index; BP, blood pressure; C-G, Cockcroft-Gault; CaRT, combination anti-retroviral therapy; CrCl, creatinine clearance; CKD, chronic kidney disease; DM, diabetes mellitus; eGFR, estimated glomerular filtration rate; HAART, highly active anti-retroviral therapy; HIV, human immunodeficiency virus; HTN, hypertension; GFR, glomerular filtration rate; GUH, Gondar University Hospital; MDRD, modification of diet in renal disease; NNRTIs, Nucleoside reverse-transcriptase inhibitors; NRTIs, nucleoside reverse-transcriptase inhibitor; PLWHA, people’s living with HIV AIDS; SAE, side effects; TDF, Tenofovir; WHO, World Health Organization.