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Abstract
Antiretroviral therapy (ART) has made a significant impact on the morbidity and mortality of patients with HIV infection. However, many of these agents have nephrotoxic potential and are implicated in causing both acute and chronic kidney disease. Safely employing these medications requires a thorough understanding of risk factors that predispose to kidney injury, which include both patient-related characteristics as well drug-related factors. Acute tubular toxicity, crystal nephropathy, and acute interstitial nephritis are among the common renal manifestations of these drugs. Adefovir and tenofovir are associated with tubular toxicity. Crystalluria, crystal nephropathy and nephrolithiasis have been established with indinavir. Acute interstitial nephritis, although not common among antiretroviral agents, is seen with indinavir and atazanavir in these immunocompromised patients. Rarely, enfuvirtide may promote a glomerulopathy. Frequent exposure to other nephrotoxic non-antiretroviral drugs also contributes to kidney disease. Identification and reversal of potentially modifiable risk factors prior to drug administration is important to limiting kidney injury. Recognition of drugrelated nephrotoxicity will promote earlier resolution of acute kidney injury and reduce the development of chronic kidney disease.
Keywords: HIV, nephrotoxicity, antiretroviral therapy, HAART, acute kidney injury, chronic kidney disease
Current Drug Safety
Title: Nephrotoxicity Associated with Antiretroviral Therapy in HIV-Infected Patients
Volume: 2 Issue: 2
Author(s): Mira Rho and Mark A. Perazella
Affiliation:
Keywords: HIV, nephrotoxicity, antiretroviral therapy, HAART, acute kidney injury, chronic kidney disease
Abstract: Antiretroviral therapy (ART) has made a significant impact on the morbidity and mortality of patients with HIV infection. However, many of these agents have nephrotoxic potential and are implicated in causing both acute and chronic kidney disease. Safely employing these medications requires a thorough understanding of risk factors that predispose to kidney injury, which include both patient-related characteristics as well drug-related factors. Acute tubular toxicity, crystal nephropathy, and acute interstitial nephritis are among the common renal manifestations of these drugs. Adefovir and tenofovir are associated with tubular toxicity. Crystalluria, crystal nephropathy and nephrolithiasis have been established with indinavir. Acute interstitial nephritis, although not common among antiretroviral agents, is seen with indinavir and atazanavir in these immunocompromised patients. Rarely, enfuvirtide may promote a glomerulopathy. Frequent exposure to other nephrotoxic non-antiretroviral drugs also contributes to kidney disease. Identification and reversal of potentially modifiable risk factors prior to drug administration is important to limiting kidney injury. Recognition of drugrelated nephrotoxicity will promote earlier resolution of acute kidney injury and reduce the development of chronic kidney disease.
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Cite this article as:
Rho Mira and Perazella A. Mark, Nephrotoxicity Associated with Antiretroviral Therapy in HIV-Infected Patients, Current Drug Safety 2007; 2 (2) . https://dx.doi.org/10.2174/157488607780598269
DOI https://dx.doi.org/10.2174/157488607780598269 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
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