Fanconi syndrome accompanied by renal function decline with tenofovir disoproxil fumarate: a prospective, case-control study of predictors and resolution in HIV-infected patients.
Fanconi syndrome accompanied by renal function decline with tenofovir disoproxil fumarate: a prospective, case-control study of predictors and resolution in HIV-infected patients.
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Fanconi综合征伴有肾上腺毒素的肾功能下降：艾滋病毒感染患者的预测因子和分辨率的前瞻性，病例对照研究。
DOI：
10.1371/journal.pone.0092717
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Wyatt CM
中科院分区：
文献类型：
--
作者：
Gupta SK;Anderson AM;Ebrahimi R;Fralich T;Graham H;Scharen-Guivel V;Flaherty JF;Fortin C;Kalayjian RC;Rachlis A;Wyatt CM
尚未评估使用抗逆转录病毒药物富马酸替诺福韦酯（TDF）后范可尼综合征（FS）伴肾功能下降的预测因素。此外，TDF停药后肾功能从FS恢复的自然史尚未得到充分描述。我们在一项多中心观察性研究中前瞻性招募了接受TDF治疗的HIV感染患者，这些患者新发现了FS（定义为至少两种近端肾小管病变的标志物，并且肌酐清除率（CrCl）较TDF治疗前下降>25%，或者在TDF治疗前没有已知CrCl的患者中，CrCl <60 mL/min）。病例组与对照组按1∶2配对，比较两组患者的特征.然后对具有已知TDF前CrCl值的病例参与者进行48周随访，以评估肾脏恢复情况。19例病例和37例对照入组。在多变量分析中，既往或同时使用洛匹那韦/利托那韦[OR 16.37，95% CI（2.28，117.68）; P = 0.006]和开始TDF前肌酐清除率降低[每降低5 mL/min OR 1.44，95% CI（1.09，1.92）; P = 0.012; TDF前CrCl低于83 mL/min OR 19.77，95% CI（2.24，174.67）; P = 0.007]与FS显著相关。 在14例随访缓解的病例中，7例（50%）至少部分缓解（定义为恢复CrCl > TDF前值的70%），尽管大多数参与者在TDF停药后两个月内近端小管病变标志物完全正常化。FS（由特异性CrCl降低和肾小管病变标志物定义）更可能发生在已经接受或目前正在接受洛匹那韦/利托那韦合并治疗或TDF开始前CrCl较低的患者中。在方案定义的FS患者中，有一半在TDF停药后第一年内CrCl恢复至接近TDF前的值。
The predictors of Fanconi syndrome (FS) accompanied by renal function decline with use of the antiretroviral tenofovir disoproxil fumarate (TDF) have not been assessed. In addition, the natural history of renal recovery from FS after TDF discontinuation is not well-described. We prospectively enrolled HIV-infected patients receiving TDF with newly identified FS (defined as at least two markers of proximal tubulopathy and either a >25% decline in creatinine clearance (CrCl) from pre-TDF values or a CrCl <60 mL/min in those without a known pre-TDF CrCl) in a multicenter observational study. These case participants were matched 1∶2 to controls; characteristics between the two groups were compared. Case participants with known pre-TDF CrCl values were then followed over 48 weeks to assess renal recovery. Nineteen cases and 37 controls were enrolled. In multivariable analysis, previous or concurrent use of lopinavir/ritonavir [OR 16.37, 95% CI (2.28, 117.68); P = 0.006] and reduced creatinine clearance prior to initiation of TDF [OR 1.44 for every 5 mL/min reduction, 95% CI (1.09, 1.92); P = 0.012; OR 19.77 for pre-TDF CrCl lower than 83 mL/min, 95% CI (2.24, 174.67); P = 0.007] were significantly associated with FS. Of the 14 cases followed for resolution, 7 (50%) achieved at least partial resolution (defined as recovering CrCl >70% of pre-TDF values) although most participants had full normalization of proximal tubulopathy markers within two months of TDF discontinuation. FS, defined by specific CrCl decreases and markers of tubulopathy, is more likely in those who have received or are currently receiving concomitant lopinavir/ritonavir or who had lower CrCl prior to TDF initiation. Half of those with protocol-defined FS had CrCl recover to near pre-TDF values during the first year after TDF discontinuation.
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影响因子：
4.9
作者：
Padilla, S;Gutiérrez, F;Orozco, C
通讯作者：
Orozco, C
影响因子：
3.7
作者：
Nishijima T;Komatsu H;Gatanaga H;Aoki T;Watanabe K;Kinai E;Honda H;Tanuma J;Yazaki H;Tsukada K;Honda M;Teruya K;Kikuchi Y;Oka S
通讯作者：
Oka S
影响因子：
19.6
作者：
Dauchy, Frederic-Antoine;Lawson-Ayayi, Sylvie;Dupon, Michel
通讯作者：
Dupon, Michel
影响因子：
19.6
作者：
Choi, A. I.;Rodriguez, R. A.;O'Hare, A. M.
通讯作者：
O'Hare, A. M.
DOI：
10.1097/qad.0b013e32834957da
发表时间：
2011-08-24
期刊：
AIDS (London, England)
影响因子：
--
作者：
Brennan A;Evans D;Maskew M;Naicker S;Ive P;Sanne I;Maotoe T;Fox M
通讯作者：
Fox M