Renal function monitoring of patients treated with tenofovir at Odi hospital in Gauteng Province, South Africa

Abstract

Tenofovir disoproxil fumarate (TDF) is an antiretroviral drug for HIV management with an adverse effect of renal dysfunction. The objectives of this study were to investigate compliance by healthcare professionals (HCPs) with the ART guidelines when monitoring renal function in patients on tenofovir, and to retrospectively examine renal function in patients initiated on TDF as part of a first-line regimen. This retrospective and observational study involved purposive sampling of 500 patient cases (65% of which were women) from a population of 4 493. The records were reviewed and audited for HCP compliance, especially for kidney function tests [serum creatinine (Scr) and creatinine clearance (CrCl)] in patients on TDF. The median Scr remained at < 100 μmol/l at all visits. Median CrCl remained stable for Kidney Disease: Improving Global Outcomes stage 2 (60-89 ml/l) of chronic kidney function. The median CD4 count increased with each visit, while the median viral load (VL) remained unsuppressed at all visits, indicating increased CKD risk. The mean monitoring intervals from baseline were wide at 11 months (visit 1), 24 months (visit 2) and 34 months (visit 4). The renal function of patients initiated and maintained on tenofovir was poorly monitored by HCPs. CD4, VL and Scr (CrCl) were not taken at every visit.

Keywords: ART, HCPs, HIV, renal, TDF.