Effect of antiretrovirals on renal function in people taking HIV pre-exposure prophylaxis.
Priscila Silva Pontes-Pereira, Rodrigo de Carvalho Santana, Elucir Gir and 1 others
PMID 41259553WHAT IT FOUND
In 203 PrEP users followed 48 weeks, kidney filtration estimates stayed mostly normal.
Mild proteinuria was uncommon, and average decline was not significant, but 3% to 4.4% had a 25% or greater drop.
Key findings
01PrEP users followed for 48 weeks had no significant reduction in eGFR by Cockcroft-Gault or CKD-EPI, and mean serum creatinine remained normal.
02No participant had moderate or severe proteinuria during follow-up, and mild proteinuria remained low and relatively stable over 48 weeks.
03A 25% or greater eGFR decline occurred in 4.4% of participants at weeks 12 and 36 and in 3% at weeks 24 and 48.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used retrospective medical records, and missing data were noted, including family and personal history, medication use, and some laboratory results. Only people with normal kidney function before starting PrEP and without diabetes were included, so results may not apply to patients with existing kidney disease or diabetes. Follow-up was 48 weeks, so longer-term kidney effects were not examined. The sample was non-probabilistic and came from four services in one municipality, with many participants from the central service and mostly young cisgender men. eGFR by Cockcroft-Gault and CKD-EPI differed considerably, so absolute values should not be compared as if interchangeable.
Declared interests
This study was financed in part by CAPES - Finance Code 001, Brazil, and was extracted from a doctoral dissertation.
The easy way to misread this
Do not read the unchanged mean eGFR as proof that PrEP has no kidney risk. The study found mild proteinuria, rare glycosuria, and 3% to 4.4% of users had a 25% or greater eGFR decline over 48 weeks.