Impact of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients
Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight. In a single-...
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| Veröffentlicht in: | PloS one 2011-07, Vol.6 (7), p.e22661 |
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| creator | Nishijima, Takeshi Komatsu, Hirokazu Gatanaga, Hiroyuki Aoki, Takahiro Watanabe, Koji Kinai, Ei Honda, Haruhito Tanuma, Junko Yazaki, Hirohisa Tsukada, Kunihisa Honda, Miwako Teruya, Katsuji Kikuchi, Yoshimi Oka, Shinichi |
| description | Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight.
In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR) from the baseline, was determined. The effects of small body weight and body mass index (BMI) on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis.
The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6%) patients (incidence: 10.5 per 100 person-years). Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p |
| doi_str_mv | 10.1371/journal.pone.0022661 |
| format | Article |
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In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR) from the baseline, was determined. The effects of small body weight and body mass index (BMI) on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis.
The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6%) patients (incidence: 10.5 per 100 person-years). Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p<0.001)(per 1 kg/m(2) decrement, HR = 1.14; 95% CI, 1.05-1.23; p = 0.001). Old age, high baseline eGFR, low serum creatinine, low CD4 count, high HIV viral load, concurrent nephrotoxic drugs, hepatitis C infection, and current smoking were also associated with tenofovir-related renal dysfunction. Multivariate analysis identified small body weight as a significant risk (adjusted HR = 1.13; 95% CI, 1.01-1.27; p = 0.039), while small BMI had marginal significance (adjusted HR = 1.07; 95% CI 1.00-1.16; p = 0.058).
The incidence of tenofovir-associated renal dysfunction in Japanese patients was high. Small body weight was identified as an independent risk factor for tenofovir-associated renal dysfunction. Close monitoring of renal function is advocated for patients with small body weight treated with tenofovir.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0022661</identifier><identifier>PMID: 21799928</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adenine - adverse effects ; Adenine - analogs & derivatives ; Adenine - therapeutic use ; Adult ; AIDS ; Analysis ; Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Asian Continental Ancestry Group ; Biology ; Body mass ; Body mass index ; Body size ; Body Weight ; Care and treatment ; CD4 antigen ; Cohort analysis ; Cohort Studies ; Creatinine ; Drugs ; Epidermal growth factor receptors ; Female ; Glomerular filtration rate ; Glomerular Filtration Rate - drug effects ; Hazards ; Hepatitis ; Hepatitis C ; Highly active antiretroviral therapy ; HIV ; HIV infections ; HIV Infections - drug therapy ; HIV Infections - physiopathology ; HIV patients ; Human immunodeficiency virus ; Humans ; Incidence ; Infection ; Infections ; Kidney - drug effects ; Kidney - physiopathology ; Male ; Medical research ; Medicine ; Middle Aged ; Multivariate Analysis ; Organophosphonates - adverse effects ; Organophosphonates - therapeutic use ; Patients ; Renal function ; Retrospective Studies ; Risk analysis ; Risk factors ; Side effects ; Smoking ; Tenofovir</subject><ispartof>PloS one, 2011-07, Vol.6 (7), p.e22661</ispartof><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Nishijima et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Nishijima et al. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c757t-a2b241775cfe4af46e2f25b7a90d22c50cbd361c26739f2b5566d9ab05e8c5753</citedby><cites>FETCH-LOGICAL-c757t-a2b241775cfe4af46e2f25b7a90d22c50cbd361c26739f2b5566d9ab05e8c5753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143186/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143186/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21799928$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Maartens, Gary</contributor><creatorcontrib>Nishijima, Takeshi</creatorcontrib><creatorcontrib>Komatsu, Hirokazu</creatorcontrib><creatorcontrib>Gatanaga, Hiroyuki</creatorcontrib><creatorcontrib>Aoki, Takahiro</creatorcontrib><creatorcontrib>Watanabe, Koji</creatorcontrib><creatorcontrib>Kinai, Ei</creatorcontrib><creatorcontrib>Honda, Haruhito</creatorcontrib><creatorcontrib>Tanuma, Junko</creatorcontrib><creatorcontrib>Yazaki, Hirohisa</creatorcontrib><creatorcontrib>Tsukada, Kunihisa</creatorcontrib><creatorcontrib>Honda, Miwako</creatorcontrib><creatorcontrib>Teruya, Katsuji</creatorcontrib><creatorcontrib>Kikuchi, Yoshimi</creatorcontrib><creatorcontrib>Oka, Shinichi</creatorcontrib><title>Impact of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight.
In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR) from the baseline, was determined. The effects of small body weight and body mass index (BMI) on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis.
The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6%) patients (incidence: 10.5 per 100 person-years). Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p<0.001)(per 1 kg/m(2) decrement, HR = 1.14; 95% CI, 1.05-1.23; p = 0.001). Old age, high baseline eGFR, low serum creatinine, low CD4 count, high HIV viral load, concurrent nephrotoxic drugs, hepatitis C infection, and current smoking were also associated with tenofovir-related renal dysfunction. Multivariate analysis identified small body weight as a significant risk (adjusted HR = 1.13; 95% CI, 1.01-1.27; p = 0.039), while small BMI had marginal significance (adjusted HR = 1.07; 95% CI 1.00-1.16; p = 0.058).
The incidence of tenofovir-associated renal dysfunction in Japanese patients was high. Small body weight was identified as an independent risk factor for tenofovir-associated renal dysfunction. Close monitoring of renal function is advocated for patients with small body weight treated with tenofovir.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adenine - adverse effects</subject><subject>Adenine - analogs & derivatives</subject><subject>Adenine - therapeutic use</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Asian Continental Ancestry Group</subject><subject>Biology</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Body Weight</subject><subject>Care and treatment</subject><subject>CD4 antigen</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Creatinine</subject><subject>Drugs</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Glomerular filtration rate</subject><subject>Glomerular Filtration Rate - drug effects</subject><subject>Hazards</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - physiopathology</subject><subject>HIV patients</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infection</subject><subject>Infections</subject><subject>Kidney - drug effects</subject><subject>Kidney - physiopathology</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Organophosphonates - adverse effects</subject><subject>Organophosphonates - therapeutic use</subject><subject>Patients</subject><subject>Renal function</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Side 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of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients</title><author>Nishijima, Takeshi ; Komatsu, Hirokazu ; Gatanaga, Hiroyuki ; Aoki, Takahiro ; Watanabe, Koji ; Kinai, Ei ; Honda, Haruhito ; Tanuma, Junko ; Yazaki, Hirohisa ; Tsukada, Kunihisa ; Honda, Miwako ; Teruya, Katsuji ; Kikuchi, Yoshimi ; Oka, Shinichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c757t-a2b241775cfe4af46e2f25b7a90d22c50cbd361c26739f2b5566d9ab05e8c5753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adenine - adverse effects</topic><topic>Adenine - analogs & derivatives</topic><topic>Adenine - therapeutic use</topic><topic>Adult</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishijima, Takeshi</au><au>Komatsu, Hirokazu</au><au>Gatanaga, Hiroyuki</au><au>Aoki, Takahiro</au><au>Watanabe, Koji</au><au>Kinai, Ei</au><au>Honda, Haruhito</au><au>Tanuma, Junko</au><au>Yazaki, Hirohisa</au><au>Tsukada, Kunihisa</au><au>Honda, Miwako</au><au>Teruya, Katsuji</au><au>Kikuchi, Yoshimi</au><au>Oka, Shinichi</au><au>Maartens, Gary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2011-07-25</date><risdate>2011</risdate><volume>6</volume><issue>7</issue><spage>e22661</spage><pages>e22661-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight.
In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR) from the baseline, was determined. The effects of small body weight and body mass index (BMI) on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis.
The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6%) patients (incidence: 10.5 per 100 person-years). Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p<0.001)(per 1 kg/m(2) decrement, HR = 1.14; 95% CI, 1.05-1.23; p = 0.001). Old age, high baseline eGFR, low serum creatinine, low CD4 count, high HIV viral load, concurrent nephrotoxic drugs, hepatitis C infection, and current smoking were also associated with tenofovir-related renal dysfunction. Multivariate analysis identified small body weight as a significant risk (adjusted HR = 1.13; 95% CI, 1.01-1.27; p = 0.039), while small BMI had marginal significance (adjusted HR = 1.07; 95% CI 1.00-1.16; p = 0.058).
The incidence of tenofovir-associated renal dysfunction in Japanese patients was high. Small body weight was identified as an independent risk factor for tenofovir-associated renal dysfunction. Close monitoring of renal function is advocated for patients with small body weight treated with tenofovir.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21799928</pmid><doi>10.1371/journal.pone.0022661</doi><tpages>e22661</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2011-07, Vol.6 (7), p.e22661 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1306226209 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Free E-Journal (出版社公開部分のみ）; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adenine - adverse effects Adenine - analogs & derivatives Adenine - therapeutic use Adult AIDS Analysis Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Asian Continental Ancestry Group Biology Body mass Body mass index Body size Body Weight Care and treatment CD4 antigen Cohort analysis Cohort Studies Creatinine Drugs Epidermal growth factor receptors Female Glomerular filtration rate Glomerular Filtration Rate - drug effects Hazards Hepatitis Hepatitis C Highly active antiretroviral therapy HIV HIV infections HIV Infections - drug therapy HIV Infections - physiopathology HIV patients Human immunodeficiency virus Humans Incidence Infection Infections Kidney - drug effects Kidney - physiopathology Male Medical research Medicine Middle Aged Multivariate Analysis Organophosphonates - adverse effects Organophosphonates - therapeutic use Patients Renal function Retrospective Studies Risk analysis Risk factors Side effects Smoking Tenofovir |
| title | Impact of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients |
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