Tenofovir is a nucleotide reverse transcriptase used to treat patients with HIV disease. Some patients may develop dysfunction of the proximal renal tubule, resulting in the renal Fanconi Syndrome.


Risk factors:

(1) decreased creatinine clearance prior to starting therapy


Clinical features of Fanconi Syndrome:

(1) polyuria

(2) polydipsia

(3) dehydaration

(4) fatigue

(5) weight loss


Laboratory findings:

(1) further decrease in creatinine clearance

(2) proteinuria

(3) phosphaturia with decreased serum phosphate

(4) glucosuria despite normal blood glucose

(5) loss of potassium in the urine with hypokalemia

(6) bicarbonate wastage with metabolic acidosis


A patient who is being treated with tenofovir should be monitored for the condition, with the drug discontinued if the syndrome develops. The disorder usually reverses once the drug is stopped.


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