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Although generally safe and well tolerated, clinicians need to be aware that TDF can cause proximal renal tubular dysfunction and loss of bone mineral density, especially in patients with concomitant renal disease or other risk factors. We present the case of a patient with chronic HIV infection and urethral stricture who developed TDF-related proximal renal tubular dysfunction with hypophosphatemia and osteomalacia, presenting with bone pains, skeletal deformity, and disability. We review risk factors for TDF-related renal tubular toxicity and recommendations for monitoring creatinine, phosphate, alkaline phosphatase, and urinalysis.<\/jats:p>","DOI":"10.1177\/2325957417718624","type":"journal-article","created":{"date-parts":[[2017,9,16]],"date-time":"2017-09-16T05:20:31Z","timestamp":1505539231000},"page":"430-432","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Chest Deformity and Disability due to Tenofovir-Induced Hypophosphatemic Osteomalacia: Case Report and Call for Improved Global Access to Laboratory Testing"],"prefix":"10.1177","volume":"16","author":[{"given":"Jan","family":"Hajek","sequence":"first","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simple","family":"Ouma","sequence":"additional","affiliation":[{"name":"Gulu Regional Referral Hospital, Gulu, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliya","family":"Hemmett","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University, London, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Starko","sequence":"additional","affiliation":[{"name":"Royal Columbian Hospital, New Westminster, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paska","family":"Apiyo","sequence":"additional","affiliation":[{"name":"Gulu Regional Referral Hospital, Gulu, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,7,10]]},"reference":[{"key":"bibr1-2325957417718624","first-page":"354908","author":"Fernandez-Fernandez B","year":"2011","journal-title":"AIDS Res Treat"},{"key":"bibr2-2325957417718624","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection","author":"World Health Organization","year":"2016"},{"key":"bibr3-2325957417718624","first-page":"008","volume":"4","author":"Tjen-A-Looi A","year":"2012","journal-title":"J AIDS Clinic Res"},{"key":"bibr4-2325957417718624","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2627-x"},{"key":"bibr5-2325957417718624","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7184.68998"},{"key":"bibr6-2325957417718624","volume-title":"Guidelines for the Prevention, Care and Treatment of Persons With Chronic Hepatitis B Infection","author":"World Health Organization","year":"2015"},{"key":"bibr7-2325957417718624","unstructured":"European AIDS Clinical Society. 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