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conferenceseries
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Volume 7, Issue 4 (Suppl)
J Clin Trial
ISSN: 2167-0870 JCTR, an open access journal
Global Pharmacovigilance 2017
July 06-07, 2017
JULY 06-07, 2017 KUALA LUMPUR, MALAYSIA
8
TH
GLOBAL
Pharmacovigilance &
Drug Safety Summit
Tenofovir-induced nephrotoxicity: Incidence, mechanism, risk factors, prognosis and proposed agents
for prevention
Atefeh Jafari
Guilan University of Medical Sciences, Iran
Objective:
In this study, we reviewed the data regarding epidemiology, risk factors, pathogenesis and outcome of Tenofovir-
induced nephrotoxicity, and discussed current and future approaches for prevention.
Method:
The data were collected by searching Scopus, PubMed, Medline, Science direct, Clinical trials and Cochrane database
systematic reviews.
Results & Conclusions:
Several predisposing factors including elevated baseline SCr, concomitant nephrotoxic medications,
low body weight, advanced age, Tenofovir disoproxil fumarate (TDF) dose and duration of treatment and lower CD4 cell count
were identified as risk factors for the development of TDF-induced nephrotoxicity. Cellular accumulation through increased
entry from the human organic anion transporters and decreased efflux into the tubular lumen is the main mechanism of
nucleotide analog antiviral-induced nephrotoxicity. Renal function assessment and monitoring at baseline and during TDF
treatment are the main approaches to prevention of TDF-induced nephrotoxicity. Rosiglitazone may be helpful in patients
presenting with TDF-induced nephrotoxicity. Pretreatment with melatonin prevented all known histological changes in
proximal tubular mitochondria induced by TDF. Use of antioxidants with mitochondrial-targeted properties such as MitoQ
or Mito-CP may prevent proximal tubular mitochondrial against TDF damage. Vitamin E, ebselen, lipoic acid, plastoquinone,
nitroxides, SOD enzyme mimetics, Szeto-Schiller peptides, and quercetin are other potential agents for prevention of
TDF-induced nephrotoxicity. However, data regarding the effectiveness of nephroprotective agents against TDF-induced
nephrotoxicity are not conclusive. Before extrapolation of the preclinical evidence to clinical practice, this evidence should be
confirmed in future human studies.
atf.jafari@gmail.comJ Clin Trial 2017, 7:4 (Suppl)
DOI: 10.4172/2167-0870-C1-017