替诺福韦酯相关肾毒性研究进展

The research progress of tenofovir disoproxil fumaraterelated nephrotoxicity

替诺福韦酯(TDF)是核苷类逆转录酶抑制剂,可有效抑制HIV、HBV病毒的复制。由于抗病毒作用强,半衰期长,可每天一次口服给药,且耐药率低,安全性较好,目前已成为HIV及HBV治疗的一线用药。但上市后,TDF致肾损伤的相关临床报道屡见不鲜,主要表现为血肌酐升高、磷酸盐水平降低等,严重者可致急性肾衰竭或范可尼综合征。本文就TDF肾损伤临床表现及其发生机制、防治措施等进行介绍,以期为临床合理使用TDF提供参考。

As a nucleotide reverse transcriptase inhibitor,tenofovir disoproxil fumarate(TDF)has been approved for the treatment of HIV and/or HBV infection.Now TDF has been the first line medicine for HIV or HBV as advantages such as good antivirus efficacy,long half-time,low drug resistance and relatively good safety.But cases of nephrotoxicity induced by TDF have been reported since the post-marketing,including increase of serum creatinine levels,hypophosphatemia,even acute kidney injury and Fanconi Syndrome(FS).The clinical manifestation of TDF-related nephrotoxicityand the mechanisms as well the prevention strategies are reviewed in this paper.