Do I think tenofovir is associated with kidney toxicity?
Based upon these 3 abstracts and other reports, I agree with the conclusions that tenofovir appears to contribute to kidney dysfunction in the setting of pre-existing kidney impairment whether it be secondary to advancing age, advanced HIV disease, other disease states and/or use of concomitant nephrotoxic medications. However, one should not over react to these findings either. Tenofovir is a potent antiretroviral agent that is generally well tolerated. At this juncture, one cannot predict per se who will develop kidney toxicity but it appears unlikely in individuals who do have normal kidney function and do not have other risk factors for kidney disease. In addition, it does appear that this decline in kidney function is reversible when one withdraws tenofovir or other contributing factors. Also, some of this decline may be artifactual as it may be secondary to improvement in body weight. It is also important to remember that it was determined that the dose of tenofovir needs to be a
