关键词: 艾滋病, 替诺福韦, 肾功能, 影响因素

Abstract: Objective To evaluate the incidence and influencing factors of chronic kidney disease （CKD） in HIV/AIDS patients with tenofovir （TDF） as the first-line treatment. Methods HIV/AIDS patients who initiated TDF-based regimens and zidovudine （AZT）-based regimens respectively were retrospectively included. Demographic characteristics and clinical information of each patient were collected, the incidence and difference of CKD between the two groups were compared, and the influencing factors of CKD in the TDF group were analyzed by Cox proportional hazard model. Results A total of 432 HIV/AIDS patients were enrolled, including 249 cases in TDF group and 193 cases in AZT group, the median age at the beginning of treatment was 32（26, 50）and 31（26, 43）years, respectively, and the transmission route was mainly homosexual transmission （accounting for 69.48% and 82.90%, respectively）. The cumulative incidence of CKD at 24 months in the TDF group and AZT group was 2.8% and 0, the difference was statistically significant （P<0.05）. At each time point, the eGFR value of AZT group was higher than that of TDF group （all P<0.01）. Cox proportional hazard model analysis showed that female （HR=57.46, 95% CI： 2.981-67.684） and patients with baseline eGFR abnormalities （HR=4.75, 95% CI： 1.351-16.702） had a higher risk of CKD in the TDF group. Conclusion TDF can cause CKD in HIV/AIDS patients, but the incidence is low. Female and patients with baseline eGFR abnormalities are at higher risk for CKD. Therefore in the process of clinical treatment, close attention should be paid to female patients and renal function should be evaluated.

Key words: AIDS, Tenofovir, Renal function, Influencing factor