Tenofovir-related acute kidney injury and proximal tubule dysfunction precipitated by diclofenac : a case of drug-drug interaction

Morelle, Johann;Labriola, Laura;Lambert, Michel;Cosyns, Jean-Pierre;Jadoul, Michel;et.al.
(2009) Clinical Nephrology — Vol. 71, n° 5, p. 567-570 (2009)

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Authors
  • Author
  • Labriola, LauraUCLouvain
    Author
  • Lambert, MichelUCLouvain
    Author
  • Cosyns, Jean-PierreUCLouvain
    Author
  • Jouret, FrançoisUCLouvain
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  • Author
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Abstract
We describe an HIV1-positive patient under long-term tenofovir treatment who developed a severe, biopsy-proven, acute tubular necrosis with proximal tubule (PT) dysfunction, precipitated by the very recent start of diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Recent studies show that NSAIDs not only alter glomerular filtration but also multidrug resistance protein (MRP) 4-mediated PT secretion of several substrates. Since the patient tolerated tenofovir well for several years prior to diclofenac use, our observation suggests that diclofenac interfered with tenofovir clearance, thereby favoring its nephrotoxicity. NSAIDs should be avoided in patients under tenofovir.
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Citations

Morelle, J., Labriola, L., Lambert, M., Cosyns, J.-P., Jouret, F., & Jadoul, M. (2009). Tenofovir-related acute kidney injury and proximal tubule dysfunction precipitated by diclofenac : a case of drug-drug interaction. Clinical Nephrology, 71(5), 567-570. https://doi.org/10.5414/CNP71567 (Original work published 2009)