{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:17:33Z","timestamp":1760300253291},"reference-count":0,"publisher":"National Institute of Public Health NIH (National Research Institute)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Przegl Epidemiol"],"abstract":"<p><strong>ABSTRACT<\/strong><br \/><strong>INTRODUCTION<\/strong>. Chronic kidney disease is a significant cause of morbidity and mortality among patients\u00a0infected with human immunodeficiency virus (HIV). Tenofovir disoproxil fumarate (TDF) is widely used as the\u00a0part of combination antiretroviral therapy (cART) and may cause renal function impairment.<br \/><strong>AIM<\/strong>. The primary objective of this analysis was to determine the rate of reversibility of kidney dysfunction and\u00a0factors correlated with eGFR improvement in patients treated with TDF.<br \/><strong>MATERIALS AND METHODS<\/strong>. All patients who discontinued TDF between 2003 and 2015 were screened\u00a0and included in the study if the reason for withdrawal was nephrotoxicity. Kidney function (eGFR, proteinuria,\u00a0haematuria) was assessed on treatment and one year after discontinuation. Factors associated with not achieving\u00a0eGFR recovery one year after discontinuing TDF were assessed.<br \/><strong>RESULTS<\/strong>. A total of 69 patients out of 1625 screened discontinued TDF due to nephrotoxicity and were included\u00a0in the analysis. At the end of the study period eGFR (CKD-EPI) improved in 52 (75,4%) patients. The eGFR\u00a0difference was 11,7 ml\/min\/1,73m2 (95% CI: 6,0 \u2013 14,5). Two factors were associated with kidney function\u00a0improvement: the length of TDF treatment and baseline eGFR. Better recovery was observed in patients treated\u00a0with shorter (difference: 15,6 ml\/min\/1,73m2, 95% CI: 5,99 \u2013 23,0) and in those with impaired renal function at\u00a0baseline (difference: 21 ml\/min\/1,73m2, 95% CI: 11,0 \u2013 27,99).<br \/><strong>CONCLUSIONS<\/strong>. In majority of patients who discontinue TDF therapy, kidney function improves during oneyear\u00a0period. The drug withdrawal in case of eGFR deterioration should not be postponed.<br \/> <br \/><strong>STRESZCZENIE<\/strong><br \/><strong>WST\u0118P<\/strong>. Przewlek\u0142a choroba nerek jest istotn\u0105 przyczyn\u0105 chorobowo\u015bci i \u015bmiertelno\u015bci u pacjent\u00f3w zaka\u017conych\u00a0HIV. Fumaran tenofowiru dizoproksylu (TDF) jest cz\u0119sto u\u017cywany w leczeniu antyretrowirusowym i mo\u017ce\u00a0powodowa\u0107 upo\u015bledzenie czynno\u015bci nerek.<br \/><strong>CELE<\/strong>. G\u0142\u00f3wnym celem pracy by\u0142o okre\u015blenie odwracalno\u015bci uszkodzenia nerek oraz czynnik\u00f3w zwi\u0105zanych\u00a0z popraw\u0105 eGFR u pacjent\u00f3w leczonych TDF po odstawieniu leku z powodu nefrotoksycznosci.<br \/><strong>MATERIA\u0141 I METODY<\/strong>. Spo\u015br\u00f3d wszystkich pacjent\u00f3w, u kt\u00f3rych odstawiono TDF mi\u0119dzy 2003 a 2015 rokiem\u00a0wybrano i w\u0142\u0105czono do badania tych, u kt\u00f3rych powodem by\u0142a nefrotoksyczno\u015b\u0107 leku. Oceniano czynno\u015b\u0107\u00a0nerek (eGFR, bia\u0142komocz, krwinkomocz) w trakcie leczenia i rok po odstawieniu TDF. Analizowano czynniki\u00a0zwi\u0105zane z popraw\u0105 eGFR po roku od odstawienia leku.<br \/><strong>WYNIKI<\/strong>. Spo\u015br\u00f3d 1625 pacjent\u00f3w u 69 przerwano leczenie TDF z powodu nefrotoksyczno\u015bci i dane tych\u00a0os\u00f3b zosta\u0142y w\u0142\u0105czone do analiz. Popraw\u0119 eGFR (CKD-EPI) w rok po zaprzestaniu leczenia obserwowano u 52\u00a0(75,4%) pacjent\u00f3w. R\u00f3\u017cnica mi\u0119dzy pomiarami eGFR wynosi\u0142a 11,7 ml\/min\/1,73m2 (95% przedzia\u0142 ufno\u015bci: 6,0\u00a0\u2013 14,5). Z popraw\u0105 czynno\u015bci nerek by\u0142y zwi\u0105zane dwa czynniki: d\u0142ugo\u015b\u0107 leczenia TDF oraz wyj\u015bciowa warto\u015b\u0107\u00a0eGFR. Wi\u0119ksz\u0105 popraw\u0119 obserwowano u pacjent\u00f3w leczonych tenofowirem kr\u00f3cej ni\u017c rok (r\u00f3\u017cnica: 15,6 ml\/min\/1,73m2, 95% przedzia\u0142 ufno\u015bci: 5,99 \u2013 23,0) oraz u os\u00f3b z wyj\u015bciowo upo\u015bledzon\u0105 czynno\u015bci\u0105 nerek (r\u00f3\u017cnica:\u00a021 ml\/min\/1,73m2, 95% przedzia\u0142 ufno\u015bci: 11,0 \u2013 27,99).<br \/><strong>WNIOSKI<\/strong>. U wi\u0119kszo\u015bci pacjent\u00f3w czynno\u015b\u0107 nerek ulega poprawie wci\u0105gu roku od odstawienia TDF. W przypadku\u00a0wyst\u0105pienia objaw\u00f3w nefrotoksyczno\u015bci nie nale\u017cy op\u00f3\u017ania\u0107 odstawienia leku.<\/p><\/jats:p>","DOI":"10.32394\/pe.73.24","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T14:25:33Z","timestamp":1564755933000},"page":"249-255","source":"Crossref","is-referenced-by-count":6,"title":["Discontinuation of tenofovir due to nephrotoxicity: insight into 12 years of clinical practice"],"prefix":"10.32394","volume":"73","author":[{"given":"B","family":"Mat\u0142osz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J D","family":"Kowalska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"B\u0105kowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Firl\u0105g-Burkacka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Vassilenko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Horban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"17323","published-online":{"date-parts":[[2019,7,25]]},"container-title":["Przeglad Epidemiologiczny"],"original-title":["Odstawienie tenofowiru z powodu nefrotoksyczno\u015bci: do\u015bwiadczenia z 12 lat praktyki klinicznej"],"link":[{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180881-101438","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180881-101438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:46:44Z","timestamp":1709887604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/Discontinuation-of-tenofovir-due-to-nephrotoxicity-insight-into-12-years-of-clinical,180881,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,25]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019]]}},"alternative-id":["180881"],"URL":"https:\/\/doi.org\/10.32394\/pe.73.24","relation":{},"ISSN":["0033-2100","2545-1898"],"issn-type":[{"value":"0033-2100","type":"print"},{"value":"2545-1898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,25]]}}}