Abstract PE11/24
A Routine Measurement of Tubular Proteinuria Does Not Predict a Subsequent eGFR Decline on Tenofovir (TDF) Treatment in a Routine Setting Print
C. Noah1, K. Schewe2, G. Mohrmann1, H.-J. Stellbrink2
1Labor Lademannbogen, Hamburg, Germany, 2ICH Study Center, Hamburg, Germany
Objective: In cohort studies TDF is associated with decreases of eGFR. It is unknown, however, if in clinical routine tubular proteinuria predicts eGFR decline on TDF treatment. We therefore wanted to assess the routine value of different parameters of tubular dysfunction for the prediction of eGFR decline.
Methods: eGFR and markers of tubular and glomerular function were assessed in a cross-sectional manner (eGFR [CKD-EPI], urinary ß2 microglobulin:creatinine ratio, urinary glucose, protein:creatinine ratio, serum phosphate) in unselected HIV+ subjects under routine care at the ICH Hamburg. 281 patients on a TDF-containing regimen and 90 subjects on a non-TDF regimen were followed prospectively for changes in eGFR.
Results: 87% were male. 88% were Caucasian. Median age was 44 years for TDF and 47 for non-TDF patients, with 43% of TDF patients receiving a PI/r. eGFR declined by a median of 4 ml/min/1.73m² (-34-45) with TDF and 3 (-39-19) in the controls. Median f/u 722 days (64-1540) for TDF and 726 days (190-1449) non-TDF patients. Urinary ß2 microglobuline:creatinine and protein:creatinine ratios were significantly higher with TDF (p< 0.000001, p=0.007, resp. [MWU]), but none of the other parameters differed significantly. In a multiple regression analysis, there was a consistent significant association of eGFR change only with baseline eGFR in both groups, regardless of the use of a PI/r.
Conclusions: Tubular proteinuria on TDF, although more frequent than without, was not independently associated with eGFR changes over a median follow-up of almost two years in this routine clinic population. The change in eGFR observed in both groups appears to depend on other factors probably reflected by baseline eGFR. A routine measurement of tubular proteinuria does not appear valuable for the prediction of an eGFR decline on TDF, although this does not exclude a prognostic value for Fanconi's syndrome.

Assigned speakers:
Prof. Dr. Hans-Jürgen Stellbrink , ICH Study Center , Hamburg , Germany

Assigned in sessions:
17.10.2013, 12:00-14:00, Poster Session, Poster Session 1, Exhibition
18.10.2013, 12:00-14:00, Poster Session, Poster Session 2, Exhibition