Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana
Identifieur interne : 000135 ( Pmc/Checkpoint ); précédent : 000134; suivant : 000136Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana
Auteurs : David R. Chadwick ; Fred S. Sarfo [Ghana] ; Elaine S. M. Kirk ; Dorcas Owusu [Ghana] ; George Bedu-Addo [Ghana] ; Victoria Parris ; Ann Lorraine Owusu [Royaume-Uni] ; Richard Phillips [Ghana]Source :
- BMC Nephrology [ 1471-2369 ] ; 2015.
Abstract
HIV infection is associated with increased risk of renal dysfunction, including tubular dysfunction (TD) related to antiretroviral therapy (ART). Tenofovir disoproxil fumarate (TDF) is becoming available for ART in sub-Saharan Africa, although data on its long-term safety there is limited. We aimed to study the prevalence of HIV-associated renal dysfunction in Ghana and explore associations between proteinuria or TD and potential risk factors, including TDF use.
A single-centre cross-sectional observational study of patients taking ART was undertaken. Creatinine clearance (CrCl) was calculated and proteinuria detected with dipsticks. Spot urinary albumin and protein:creatinine ratios (uACR/uPCR) were measured and further evidence of TD (defined as having two or more characteristic features) sought. Logistic regression analysis identified factors associated with proteinuria or TD.
In 330 patients, of whom 101 were taking TDF (median 20 months), the prevalence of CrCl < 60ml/min/1.73m2, dipstick proteinuria and TD was 7 %, 37 % and 15 %. Factors associated with proteinuria were baseline CD4-count [aOR 0.86/100 cell increment (95 % CI, 0.74–0.99)] and TDF use [aOR 2.74 (95 % CI, 1.38–5.43)]. The only factor associated with TD was TDF use [aOR 3.43 (95 % CI, 1.10–10.69)]. In a subset with uPCR measurements, uPCRs were significantly higher in patients taking TDF than those on other drugs (10.8
Both proteinuria and TD are common and associated with TDF use in Ghana. Further longitudinal studies to determine whether proteinuria, TD or TDF use are linked to progressive decline in renal function or other adverse outcomes are needed in Africa.
Url:
DOI: 10.1186/s12882-015-0192-4
PubMed: 26627687
PubMed Central: 4666076
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
PMC:4666076Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana</title><author><name sortKey="Chadwick, David R" sort="Chadwick, David R" uniqKey="Chadwick D" first="David R." last="Chadwick">David R. Chadwick</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S." last="Sarfo">Fred S. Sarfo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Kirk, Elaine S M" sort="Kirk, Elaine S M" uniqKey="Kirk E" first="Elaine S. M." last="Kirk">Elaine S. M. Kirk</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Owusu, Dorcas" sort="Owusu, Dorcas" uniqKey="Owusu D" first="Dorcas" last="Owusu">Dorcas Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Parris, Victoria" sort="Parris, Victoria" uniqKey="Parris V" first="Victoria" last="Parris">Victoria Parris</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Owusu, Ann Lorraine" sort="Owusu, Ann Lorraine" uniqKey="Owusu A" first="Ann Lorraine" last="Owusu">Ann Lorraine Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff4">University of Leicester, Leicester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Leicester, Leicester</wicri:regionArea><wicri:noRegion>Leicester</wicri:noRegion></affiliation></author><author><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26627687</idno><idno type="pmc">4666076</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666076</idno><idno type="RBID">PMC:4666076</idno><idno type="doi">10.1186/s12882-015-0192-4</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000104</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000104</idno><idno type="wicri:Area/Pmc/Curation">000103</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000103</idno><idno type="wicri:Area/Pmc/Checkpoint">000135</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000135</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana</title><author><name sortKey="Chadwick, David R" sort="Chadwick, David R" uniqKey="Chadwick D" first="David R." last="Chadwick">David R. Chadwick</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S." last="Sarfo">Fred S. Sarfo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Kirk, Elaine S M" sort="Kirk, Elaine S M" uniqKey="Kirk E" first="Elaine S. M." last="Kirk">Elaine S. M. Kirk</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Owusu, Dorcas" sort="Owusu, Dorcas" uniqKey="Owusu D" first="Dorcas" last="Owusu">Dorcas Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Parris, Victoria" sort="Parris, Victoria" uniqKey="Parris V" first="Victoria" last="Parris">Victoria Parris</name><affiliation><nlm:aff id="Aff1">Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</nlm:aff><wicri:noCountry code="subfield">TS4 3BW UK</wicri:noCountry></affiliation></author><author><name sortKey="Owusu, Ann Lorraine" sort="Owusu, Ann Lorraine" uniqKey="Owusu A" first="Ann Lorraine" last="Owusu">Ann Lorraine Owusu</name><affiliation wicri:level="1"><nlm:aff id="Aff4">University of Leicester, Leicester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Leicester, Leicester</wicri:regionArea><wicri:noRegion>Leicester</wicri:noRegion></affiliation></author><author><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science & Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Nephrology</title><idno type="eISSN">1471-2369</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>HIV infection is associated with increased risk of renal dysfunction, including tubular dysfunction (TD) related to antiretroviral therapy (ART). Tenofovir disoproxil fumarate (TDF) is becoming available for ART in sub-Saharan Africa, although data on its long-term safety there is limited. We aimed to study the prevalence of HIV-associated renal dysfunction in Ghana and explore associations between proteinuria or TD and potential risk factors, including TDF use.</p></sec><sec><title>Methods</title><p>A single-centre cross-sectional observational study of patients taking ART was undertaken. Creatinine clearance (CrCl) was calculated and proteinuria detected with dipsticks. Spot urinary albumin and protein:creatinine ratios (uACR/uPCR) were measured and further evidence of TD (defined as having two or more characteristic features) sought. Logistic regression analysis identified factors associated with proteinuria or TD.</p></sec><sec><title>Results</title><p>In 330 patients, of whom 101 were taking TDF (median 20 months), the prevalence of CrCl < 60ml/min/1.73m<sup>2</sup>, dipstick proteinuria and TD was 7 %, 37 % and 15 %. Factors associated with proteinuria were baseline CD4-count [aOR 0.86/100 cell increment (95 % CI, 0.74–0.99)] and TDF use [aOR 2.74 (95 % CI, 1.38–5.43)]. The only factor associated with TD was TDF use [aOR 3.43 (95 % CI, 1.10–10.69)]. In a subset with uPCR measurements, uPCRs were significantly higher in patients taking TDF than those on other drugs (10.8 <italic>vs.</italic> 5.7 mg/mmol, <italic>p</italic> < 0.001), and urinary albuin:protein ratios significantly lower (0.24 <italic>vs.</italic> 0.58, <italic>p</italic> < 0.001).</p></sec><sec><title>Conclusions</title><p>Both proteinuria and TD are common and associated with TDF use in Ghana. Further longitudinal studies to determine whether proteinuria, TD or TDF use are linked to progressive decline in renal function or other adverse outcomes are needed in Africa.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Szczech, La" uniqKey="Szczech L">LA Szczech</name></author><author><name sortKey="Gange, Sj" uniqKey="Gange S">SJ Gange</name></author><author><name sortKey="Van Der Horst, C" uniqKey="Van Der Horst C">C van der Horst</name></author><author><name sortKey="Bartlett, Ja" uniqKey="Bartlett J">JA Bartlett</name></author><author><name sortKey="Young, M" uniqKey="Young M">M Young</name></author><author><name sortKey="Cohen, Mh" uniqKey="Cohen M">MH Cohen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mocroft, A" uniqKey="Mocroft A">A Mocroft</name></author><author><name sortKey="Kirk, O" uniqKey="Kirk O">O Kirk</name></author><author><name sortKey="Reiss, P" uniqKey="Reiss P">P Reiss</name></author><author><name sortKey="De Wit, S" uniqKey="De Wit S">S De Wit</name></author><author><name sortKey="Sedlacek, D" uniqKey="Sedlacek D">D Sedlacek</name></author><author><name sortKey="Beniowski, M" uniqKey="Beniowski M">M Beniowski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Daar, Es" uniqKey="Daar E">ES Daar</name></author><author><name sortKey="Tierney, C" uniqKey="Tierney C">C Tierney</name></author><author><name sortKey="Fischl, Ma" uniqKey="Fischl M">MA Fischl</name></author><author><name sortKey="Sax, Pe" uniqKey="Sax P">PE Sax</name></author><author><name sortKey="Mollan, K" uniqKey="Mollan K">K Mollan</name></author><author><name sortKey="Budhathoki, C" uniqKey="Budhathoki C">C Budhathoki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campbell, Lj" uniqKey="Campbell L">LJ Campbell</name></author><author><name sortKey="Ibrahim, F" uniqKey="Ibrahim F">F Ibrahim</name></author><author><name sortKey="Fisher, M" uniqKey="Fisher M">M Fisher</name></author><author><name sortKey="Holt, Sg" uniqKey="Holt S">SG Holt</name></author><author><name sortKey="Hendry, Bm" uniqKey="Hendry B">BM Hendry</name></author><author><name sortKey="Post, Fa" uniqKey="Post F">FA Post</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lucas, Gm" uniqKey="Lucas G">GM Lucas</name></author><author><name sortKey="Eustace, Ja" uniqKey="Eustace J">JA Eustace</name></author><author><name sortKey="Sozio, S" uniqKey="Sozio S">S Sozio</name></author><author><name sortKey="Mentari, Ek" uniqKey="Mentari E">EK Mentari</name></author><author><name sortKey="Appiah, Ka" uniqKey="Appiah K">KA Appiah</name></author><author><name sortKey="Moore, Rd" uniqKey="Moore R">RD Moore</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Atta, Mg" uniqKey="Atta M">MG Atta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reid, A" uniqKey="Reid A">A Reid</name></author><author><name sortKey="Stohr, W" uniqKey="Stohr W">W Stöhr</name></author><author><name sortKey="Walker, As" uniqKey="Walker A">AS Walker</name></author><author><name sortKey="Williams, Ig" uniqKey="Williams I">IG Williams</name></author><author><name sortKey="Kityo, C" uniqKey="Kityo C">C Kityo</name></author><author><name sortKey="Hughes, P" uniqKey="Hughes P">P Hughes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gupta, Sk" uniqKey="Gupta S">SK Gupta</name></author><author><name sortKey="Parker, Ra" uniqKey="Parker R">RA Parker</name></author><author><name sortKey="Robbins, Gk" uniqKey="Robbins G">GK Robbins</name></author><author><name sortKey="Dube, Mp" uniqKey="Dube M">MP Dubé</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kopp, Jb" uniqKey="Kopp J">JB Kopp</name></author><author><name sortKey="Winkler, C" uniqKey="Winkler C">C Winkler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rostand, Sg" uniqKey="Rostand S">SG Rostand</name></author><author><name sortKey="Kirk, Ka" uniqKey="Kirk K">KA Kirk</name></author><author><name sortKey="Rutsky, Ea" uniqKey="Rutsky E">EA Rutsky</name></author><author><name sortKey="Pate, Ba" uniqKey="Pate B">BA Pate</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klag, Mj" uniqKey="Klag M">MJ Klag</name></author><author><name sortKey="Whelton, Pk" uniqKey="Whelton P">PK Whelton</name></author><author><name sortKey="Randall, Bl" uniqKey="Randall B">BL Randall</name></author><author><name sortKey="Neaton, Jd" uniqKey="Neaton J">JD Neaton</name></author><author><name sortKey="Brancati, Fl" uniqKey="Brancati F">FL Brancati</name></author><author><name sortKey="Stamler, J" uniqKey="Stamler J">J Stamler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Padulles, A" uniqKey="Padulles A">A Padullés</name></author><author><name sortKey="Rama, I" uniqKey="Rama I">I Rama</name></author><author><name sortKey="Llaudo, I" uniqKey="Llaudo I">I Llaudo</name></author><author><name sortKey="Lloberas, N" uniqKey="Lloberas N">N Lloberas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Okafor, Uh" uniqKey="Okafor U">UH Okafor</name></author><author><name sortKey="Unuigbe, Ei" uniqKey="Unuigbe E">EI Unuigbe</name></author><author><name sortKey="Ojogwu, Li" uniqKey="Ojogwu L">LI Ojogwu</name></author><author><name sortKey="Oviasu, E" uniqKey="Oviasu E">E Oviasu</name></author><author><name sortKey="Wokoma, Fs" uniqKey="Wokoma F">FS Wokoma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fabian, J" uniqKey="Fabian J">J Fabian</name></author><author><name sortKey="Naicker, S" uniqKey="Naicker S">S Naicker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wools Kaloustian, K" uniqKey="Wools Kaloustian K">K Wools-Kaloustian</name></author><author><name sortKey="Gupta, Sk" uniqKey="Gupta S">SK Gupta</name></author><author><name sortKey="Muloma, E" uniqKey="Muloma E">E Muloma</name></author><author><name sortKey="Owino Ong Or, W" uniqKey="Owino Ong Or W">W Owino-Ong'or</name></author><author><name sortKey="Sidle, J" uniqKey="Sidle J">J Sidle</name></author><author><name sortKey="Aubrey, Rw" uniqKey="Aubrey R">RW Aubrey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sarfo, Fs" uniqKey="Sarfo F">FS Sarfo</name></author><author><name sortKey="Keegan, R" uniqKey="Keegan R">R Keegan</name></author><author><name sortKey="Appiah, L" uniqKey="Appiah L">L Appiah</name></author><author><name sortKey="Shakoor, S" uniqKey="Shakoor S">S Shakoor</name></author><author><name sortKey="Phillips, R" uniqKey="Phillips R">R Phillips</name></author><author><name sortKey="Norman, B" uniqKey="Norman B">B Norman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Han, Tm" uniqKey="Han T">TM Han</name></author><author><name sortKey="Naicker, S" uniqKey="Naicker S">S Naicker</name></author><author><name sortKey="Ramdial, Pk" uniqKey="Ramdial P">PK Ramdial</name></author><author><name sortKey="Assounga, Ag" uniqKey="Assounga A">AG Assounga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mulenga, Lb" uniqKey="Mulenga L">LB Mulenga</name></author><author><name sortKey="Kruse, G" uniqKey="Kruse G">G Kruse</name></author><author><name sortKey="Lakhi, S" uniqKey="Lakhi S">S Lakhi</name></author><author><name sortKey="Cantrell, Ra" uniqKey="Cantrell R">RA Cantrell</name></author><author><name sortKey="Reid, Se" uniqKey="Reid S">SE Reid</name></author><author><name sortKey="Zulu, I" uniqKey="Zulu I">I Zulu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jao, J" uniqKey="Jao J">J Jao</name></author><author><name sortKey="Lo, W" uniqKey="Lo W">W Lo</name></author><author><name sortKey="Toro, Pl" uniqKey="Toro P">PL Toro</name></author><author><name sortKey="Wyatt, C" uniqKey="Wyatt C">C Wyatt</name></author><author><name sortKey="Palmer, D" uniqKey="Palmer D">D Palmer</name></author><author><name sortKey="Abrams, Ej" uniqKey="Abrams E">EJ Abrams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rodriguez N Voa, S" uniqKey="Rodriguez N Voa S">S Rodriguez-Nóvoa</name></author><author><name sortKey="Labarga, P" uniqKey="Labarga P">P Labarga</name></author><author><name sortKey="Soriano, V" uniqKey="Soriano V">V Soriano</name></author><author><name sortKey="Egan, D" uniqKey="Egan D">D Egan</name></author><author><name sortKey="Albalater, M" uniqKey="Albalater M">M Albalater</name></author><author><name sortKey="Morello, J" uniqKey="Morello J">J Morello</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Squires, K" uniqKey="Squires K">K Squires</name></author><author><name sortKey="Pozniak, Al" uniqKey="Pozniak A">AL Pozniak</name></author><author><name sortKey="Pierone, G" uniqKey="Pierone G">G Pierone</name></author><author><name sortKey="Steinhart, Cr" uniqKey="Steinhart C">CR Steinhart</name></author><author><name sortKey="Berger, D" uniqKey="Berger D">D Berger</name></author><author><name sortKey="Bellos, Nc" uniqKey="Bellos N">NC Bellos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gallant, Je" uniqKey="Gallant J">JE Gallant</name></author><author><name sortKey="Staszewski, S" uniqKey="Staszewski S">S Staszewski</name></author><author><name sortKey="Pozniak, Al" uniqKey="Pozniak A">AL Pozniak</name></author><author><name sortKey="Dejesus, E" uniqKey="Dejesus E">E DeJesus</name></author><author><name sortKey="Suleiman, Jm" uniqKey="Suleiman J">JM Suleiman</name></author><author><name sortKey="Miller, Md" uniqKey="Miller M">MD Miller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Quimby, D" uniqKey="Quimby D">D Quimby</name></author><author><name sortKey="Brito, Mo" uniqKey="Brito M">MO Brito</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Malik, A" uniqKey="Malik A">A Malik</name></author><author><name sortKey="Abraham, P" uniqKey="Abraham P">P Abraham</name></author><author><name sortKey="Malik, N" uniqKey="Malik N">N Malik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Young, B" uniqKey="Young B">B Young</name></author><author><name sortKey="Buchacz, K" uniqKey="Buchacz K">K Buchacz</name></author><author><name sortKey="Baker, Rk" uniqKey="Baker R">RK Baker</name></author><author><name sortKey="Moorman, Ac" uniqKey="Moorman A">AC Moorman</name></author><author><name sortKey="Wood, Kc" uniqKey="Wood K">KC Wood</name></author><author><name sortKey="Chmiel, J" uniqKey="Chmiel J">J Chmiel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Solomon, Mm" uniqKey="Solomon M">MM Solomon</name></author><author><name sortKey="Lama, Jr" uniqKey="Lama J">JR Lama</name></author><author><name sortKey="Glidden, Dv" uniqKey="Glidden D">DV Glidden</name></author><author><name sortKey="Mulligan, K" uniqKey="Mulligan K">K Mulligan</name></author><author><name sortKey="Mcmahan, V" uniqKey="Mcmahan V">V McMahan</name></author><author><name sortKey="Liu, Ay" uniqKey="Liu A">AY Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Purswani, M" uniqKey="Purswani M">M Purswani</name></author><author><name sortKey="Patel, K" uniqKey="Patel K">K Patel</name></author><author><name sortKey="Kopp, Jb" uniqKey="Kopp J">JB Kopp</name></author><author><name sortKey="Seage, Gr" uniqKey="Seage G">GR Seage</name></author><author><name sortKey="Chernoff, Mc" uniqKey="Chernoff M">MC Chernoff</name></author><author><name sortKey="Hazra, R" uniqKey="Hazra R">R Hazra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reynes, J" uniqKey="Reynes J">J Reynes</name></author><author><name sortKey="Cournil, A" uniqKey="Cournil A">A Cournil</name></author><author><name sortKey="Peyriere, H" uniqKey="Peyriere H">H Peyriere</name></author><author><name sortKey="Psomas, C" uniqKey="Psomas C">C Psomas</name></author><author><name sortKey="Guiller, E" uniqKey="Guiller E">E Guiller</name></author><author><name sortKey="Chatron, M" uniqKey="Chatron M">M Chatron</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dauchy, Fa" uniqKey="Dauchy F">FA Dauchy</name></author><author><name sortKey="Lawson Ayayi, S" uniqKey="Lawson Ayayi S">S Lawson-Ayayi</name></author><author><name sortKey="De La Faille, R" uniqKey="De La Faille R">R de La Faille</name></author><author><name sortKey="Bonnet, F" uniqKey="Bonnet F">F Bonnet</name></author><author><name sortKey="Rigothier, C" uniqKey="Rigothier C">C Rigothier</name></author><author><name sortKey="Mehsen, N" uniqKey="Mehsen N">N Mehsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Labarga, P" uniqKey="Labarga P">P Labarga</name></author><author><name sortKey="Barreiro, P" uniqKey="Barreiro P">P Barreiro</name></author><author><name sortKey="Martin Carbonero, L" uniqKey="Martin Carbonero L">L Martin-Carbonero</name></author><author><name sortKey="Rodriguez Novoa, S" uniqKey="Rodriguez Novoa S">S Rodriguez-Novoa</name></author><author><name sortKey="Solera, C" uniqKey="Solera C">C Solera</name></author><author><name sortKey="Medrano, J" uniqKey="Medrano J">J Medrano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stohr, W" uniqKey="Stohr W">W Stöhr</name></author><author><name sortKey="Reid, A" uniqKey="Reid A">A Reid</name></author><author><name sortKey="Walker, As" uniqKey="Walker A">AS Walker</name></author><author><name sortKey="Ssali, F" uniqKey="Ssali F">F Ssali</name></author><author><name sortKey="Munderi, P" uniqKey="Munderi P">P Munderi</name></author><author><name sortKey="Mambule, I" uniqKey="Mambule I">I Mambule</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mulenga, L" uniqKey="Mulenga L">L Mulenga</name></author><author><name sortKey="Musonda, P" uniqKey="Musonda P">P Musonda</name></author><author><name sortKey="Mwango, A" uniqKey="Mwango A">A Mwango</name></author><author><name sortKey="Vinikoor, Mj" uniqKey="Vinikoor M">MJ Vinikoor</name></author><author><name sortKey="Davies, Ma" uniqKey="Davies M">MA Davies</name></author><author><name sortKey="Mweemba, A" uniqKey="Mweemba A">A Mweemba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Geretti, Am" uniqKey="Geretti A">AM Geretti</name></author><author><name sortKey="Patel, M" uniqKey="Patel M">M Patel</name></author><author><name sortKey="Sarfo, Fs" uniqKey="Sarfo F">FS Sarfo</name></author><author><name sortKey="Chadwick, D" uniqKey="Chadwick D">D Chadwick</name></author><author><name sortKey="Verheyen, J" uniqKey="Verheyen J">J Verheyen</name></author><author><name sortKey="Fraune, M" uniqKey="Fraune M">M Fraune</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mocroft, A" uniqKey="Mocroft A">A Mocroft</name></author><author><name sortKey="Neuhaus, J" uniqKey="Neuhaus J">J Neuhaus</name></author><author><name sortKey="Peters, L" uniqKey="Peters L">L Peters</name></author><author><name sortKey="Ryom, L" uniqKey="Ryom L">L Ryom</name></author><author><name sortKey="Bickel, M" uniqKey="Bickel M">M Bickel</name></author><author><name sortKey="Grint, D" uniqKey="Grint D">D Grint</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Del Palacio, M" uniqKey="Del Palacio M">M Del Palacio</name></author><author><name sortKey="Romero, S" uniqKey="Romero S">S Romero</name></author><author><name sortKey="Casado, Jl" uniqKey="Casado J">JL Casado</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Msango, L" uniqKey="Msango L">L Msango</name></author><author><name sortKey="Downs, Ja" uniqKey="Downs J">JA Downs</name></author><author><name sortKey="Kalluvva, Se" uniqKey="Kalluvva S">SE Kalluvva</name></author><author><name sortKey="Kidenya, Br" uniqKey="Kidenya B">BR Kidenya</name></author><author><name sortKey="Kabangila, R" uniqKey="Kabangila R">R Kabangila</name></author><author><name sortKey="Johnson, Wd" uniqKey="Johnson W">WD Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sise, Me" uniqKey="Sise M">ME Sise</name></author><author><name sortKey="Hirsch, Js" uniqKey="Hirsch J">JS Hirsch</name></author><author><name sortKey="Canetta, Pa" uniqKey="Canetta P">PA Canetta</name></author><author><name sortKey="Herlitz, L" uniqKey="Herlitz L">L Herlitz</name></author><author><name sortKey="Mohan, S" uniqKey="Mohan S">S Mohan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mills, A" uniqKey="Mills A">A Mills</name></author><author><name sortKey="Crofoot, G" uniqKey="Crofoot G">G Crofoot</name></author><author><name sortKey="Mcdonald, C" uniqKey="Mcdonald C">C McDonald</name></author><author><name sortKey="Shalit, P" uniqKey="Shalit P">P Shalit</name></author><author><name sortKey="Flamm, Ja" uniqKey="Flamm J">JA Flamm</name></author><author><name sortKey="Gathe, J" uniqKey="Gathe J">J Gathe</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Nephrol</journal-id><journal-id journal-id-type="iso-abbrev">BMC Nephrol</journal-id><journal-title-group><journal-title>BMC Nephrology</journal-title></journal-title-group><issn pub-type="epub">1471-2369</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26627687</article-id><article-id pub-id-type="pmc">4666076</article-id><article-id pub-id-type="publisher-id">192</article-id><article-id pub-id-type="doi">10.1186/s12882-015-0192-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Chadwick</surname><given-names>David R.</given-names></name><address><phone>44 1642 854429</phone><email>davidr.chadwick@stees.nhs.uk</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Sarfo</surname><given-names>Fred S.</given-names></name><address><email>stephensarfo78@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Kirk</surname><given-names>Elaine S. M.</given-names></name><address><email>esmkirk@msn.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Owusu</surname><given-names>Dorcas</given-names></name><address><email>dokidinks@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Bedu-Addo</surname><given-names>George</given-names></name><address><email>gbeduaddo@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Parris</surname><given-names>Victoria</given-names></name><address><email>victoria.parris@stees.nhs.uk</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Owusu</surname><given-names>Ann Lorraine</given-names></name><address><email>l_owusu44@hotmail.com</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Phillips</surname><given-names>Richard</given-names></name><address><email>rodamephillips@gmail.com</email></address><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><aff id="Aff1"><label></label>Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, TS4 3BW UK</aff><aff id="Aff2"><label></label>Kwame Nkrumah University of Science & Technology, Kumasi, Ghana</aff><aff id="Aff3"><label></label>Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff><aff id="Aff4"><label></label>University of Leicester, Leicester, UK</aff></contrib-group><pub-date pub-type="epub"><day>1</day><month>12</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>12</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>16</volume><elocation-id>195</elocation-id><history><date date-type="received"><day>24</day><month>6</month><year>2015</year></date><date date-type="accepted"><day>24</day><month>11</month><year>2015</year></date></history><permissions><copyright-statement>© Chadwick et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>HIV infection is associated with increased risk of renal dysfunction, including tubular dysfunction (TD) related to antiretroviral therapy (ART). Tenofovir disoproxil fumarate (TDF) is becoming available for ART in sub-Saharan Africa, although data on its long-term safety there is limited. We aimed to study the prevalence of HIV-associated renal dysfunction in Ghana and explore associations between proteinuria or TD and potential risk factors, including TDF use.</p></sec><sec><title>Methods</title><p>A single-centre cross-sectional observational study of patients taking ART was undertaken. Creatinine clearance (CrCl) was calculated and proteinuria detected with dipsticks. Spot urinary albumin and protein:creatinine ratios (uACR/uPCR) were measured and further evidence of TD (defined as having two or more characteristic features) sought. Logistic regression analysis identified factors associated with proteinuria or TD.</p></sec><sec><title>Results</title><p>In 330 patients, of whom 101 were taking TDF (median 20 months), the prevalence of CrCl < 60ml/min/1.73m<sup>2</sup>, dipstick proteinuria and TD was 7 %, 37 % and 15 %. Factors associated with proteinuria were baseline CD4-count [aOR 0.86/100 cell increment (95 % CI, 0.74–0.99)] and TDF use [aOR 2.74 (95 % CI, 1.38–5.43)]. The only factor associated with TD was TDF use [aOR 3.43 (95 % CI, 1.10–10.69)]. In a subset with uPCR measurements, uPCRs were significantly higher in patients taking TDF than those on other drugs (10.8 <italic>vs.</italic> 5.7 mg/mmol, <italic>p</italic> < 0.001), and urinary albuin:protein ratios significantly lower (0.24 <italic>vs.</italic> 0.58, <italic>p</italic> < 0.001).</p></sec><sec><title>Conclusions</title><p>Both proteinuria and TD are common and associated with TDF use in Ghana. Further longitudinal studies to determine whether proteinuria, TD or TDF use are linked to progressive decline in renal function or other adverse outcomes are needed in Africa.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>HIV</kwd><kwd>Kidney</kwd><kwd>Renal</kwd><kwd>TDF</kwd><kwd>Tubular</kwd><kwd>Africa</kwd><kwd>Antiretroviral therapy</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Ghana</li><li>Royaume-Uni</li></country></list><tree><noCountry><name sortKey="Chadwick, David R" sort="Chadwick, David R" uniqKey="Chadwick D" first="David R." last="Chadwick">David R. Chadwick</name><name sortKey="Kirk, Elaine S M" sort="Kirk, Elaine S M" uniqKey="Kirk E" first="Elaine S. M." last="Kirk">Elaine S. M. Kirk</name><name sortKey="Parris, Victoria" sort="Parris, Victoria" uniqKey="Parris V" first="Victoria" last="Parris">Victoria Parris</name></noCountry><country name="Ghana"><noRegion><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S." last="Sarfo">Fred S. Sarfo</name></noRegion><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><name sortKey="Owusu, Dorcas" sort="Owusu, Dorcas" uniqKey="Owusu D" first="Dorcas" last="Owusu">Dorcas Owusu</name><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S." last="Sarfo">Fred S. Sarfo</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Owusu, Ann Lorraine" sort="Owusu, Ann Lorraine" uniqKey="Owusu A" first="Ann Lorraine" last="Owusu">Ann Lorraine Owusu</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Pmc/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000135 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd -nk 000135 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Pmc
|étape= Checkpoint
|type= RBID
|clé= PMC:4666076
|texte= Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i -Sk "pubmed:26627687" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd \
| NlmPubMed2Wicri -a SidaGhanaV1
| This area was generated with Dilib version V0.6.31. |  |