To better evaluate the renal safety profile of tenofovir, we performed a retrospective study of HIV-infected naïve patients starting a first antiretroviral therapy between July 2005 and July 2008, and followed-up for 24 months. On the whole, 324 patients were enrolled: 201 tenofovir-exposed patients were compared with 123 tenofovir-unexposed subjects. In both unadjusted and adjusted analysis, tenofovir-exposed subjects had a significantly greater decline in glomerular filtration rate (GFR), and a significantly higher incidence of proximal tubular dysfunction through 24 months. Reduced glomerular and tubular functions were significantly associated with older age, diabetes, hypertension, and concomitant therapy with a HIV protease inhibitor.
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