Introduction: Tenofovir remains the cornerstone drug in various antiretroviral regimens and is commonly associated with renal failure in susceptible individuals with a renal biopsy suggestive of proximal tubular injury. Objectives: To investigate clinical, histopathological and outcome findings in tenofovir-induced nephrotoxicity patients. Patients and Methods: Between August 1, 2014, and March 31, 2017, an observational study was conducted in a government-run tertiary care facility in South India. All patients receiving a regimen based on tenofovir disoproxil fumarate (TDF) and testing positive for human immunodeficiency virus (HIV) were included. A renal biopsy was performed when needed. Results: A total of 27 cases were identified, with a mean age of 45.03± 12.95 years, while 19 (70%) of them were men. Mean creatinine and mean proteinuria among the participants were 5.78 ±2.71 mg/dL and 1643.96 ±1056.44 mg/dL, respectively, at the time of the renal biopsy. Interval between TDF treatments to kidney biopsies ranged between 7 to 52 weeks with mean (±SD) of 30.8±22 weeks. Phosphaturia and glycosuria were found in 10 (37.03%) and 8 (29.5%) patients respectively, all of whom had normoglycemia. In contrast to the remaining 13 instances, which all had moderate to severe diffuse inflammation, 14 patients exhibited toxic proximal tubular damage along with mild and localized interstitial inflammation. Hemodialysis was required by 10 individuals. A total of 22 patients were monitored after TDF was stopped, while 17 (77.27%) of them had fully recovered renal function at the end of monitoring period. Conclusion: This study demonstrates that TDF nephrotoxicity is a reversible form of toxic acute tubular necrosis with concurrent interstitial inflammation that affects the proximal tubules. As a result, it is crucial to carefully monitor renal parameters in these patients.
Tobacco smoking is an universal problem. There are about 120 million smokers in India in the age group of 30-69 years and have an increased cardiovascular and renal risks in addition to other risks attributable to smoking..The present study was aimed to assess the cardiovascular and renal risks especially among the young smokers in the age group of 20-40 years. After all necessary administrative and ethical clearances a cross sectional study was conducted at the tertiary care medical college hospital located at Mangalore. 75 young male smokers in the age group of 20-40 years along with equal number of age, sex matched non smokers as controls were recruited and each one were assessed for Blood pressure(BP), Electro cardiographic changes(ECG changes), and Glomerular filtration rate(GFR).In the present study Smoking resulted in high systolic blood pressure and prolonged QT interval (QTc) as compared to the non smokers, thus increasing the risk of Sudden cardiac death among smokers. Longer duration of smoking of more than 10 years resulted in Pre hypertension and reduced GFR in comparison to smokers with lesser duration of smoking of less than 10 years.This study highlights the need to tackle “Smoking” among young adults more aggressively to avoid the potential cardiovascular and renal complications, as Tobacco smoking is a major modifiable risk factor for the same.
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