Table 2 Characteristics of included studies
From: Tenofovir-associated kidney disease in Africans: a systematic review
Author: year | Setting/Region* | Age group of interest | Design | Sample size (on TDF containing regimen) | Treatment regimen | Comparator | Duration on ART at baseline | Duration of follow up | Outcome measurements |
|---|---|---|---|---|---|---|---|---|---|
Mulenga: 2014 | Zambia: SA | ≥16 years | RC | 62,230 (38,716) | TDF-based regimen | Non TDF containing | – | 12 months | eGFR by CKD-EPI |
De Waal: 2017 | South Africa: SA | ≥ 16 years | RC | 15,156 (15,156) | TDF containing | – | Median 12.9 months | – | eGFR using MDRD, CKD-EPI and CG. No factor for black race used |
Ndagije: 2015 | Uganda; EA | Adults | Implementation: (TSR) | 10,225 (53) | TDF based | – | > 2 years | 2 years | SCr, urinalysis, clinical signs and symptoms |
Reid: 2008 | DART: Uganda and Zimbabwe | ≥16 years | OC within RCT | 3316 (2469) | TDF/3TC/AZT | Non TDF | Naïve at baseline | 96 weeks | Creatinine levels and eGFR by CG |
Stöhr: 2011 | South Africa: SA | Adults | OC within RCT | 3316 (2469) | TDF/3TC/AZT | Non TDF | Naïve at baseline | 96 weeks | eGFR by CG |
Shamu: 2015 | Zimbabwe: SA | Adults ≥ 18yrs | RC | 1986 (1862) | TDF containing | Non TDF |  | 6411 person yrs | Two consecutive CrCl < 60 ml/min by the CG equation, or two consecutive urine dipsticks positive for protein (≥ 30 g/L albumin) |
Myer, 2013 | South Africa: SA | Women ≥ 25 years | RC | 1861 (238) | TDF, 3TC/FTC, and EFV | Men and non-pregnant women, similar regimen | initiating Rx | 2 years | CrCl and absolute serum creatinine values |
Dekert: 2017 | Zambia; SA | ≥16 years | RC | 1118 (1118) | TDF containing | – | ≥ 90 days | Median 1461 days | eGFR, CKD-Epi formula |
Mayanja: 2017 | Uganda; EA | Adults | PC | 1095 (608) | TDF containing | 236 on a PI + other | ≥6 months, Median 9.4 years |  | sUrea, sCr, Fractional Tubular phosphates reabsorption & eGFR. (CG/MDRD/CKD-Epi) |
Kamkuemah: 2015 | South Africa: SA | Adults | Cohort | 1092 (1092) | TenolamE | – | initiating ART | 12 months | CrCl after 12 months on ART measured by glomerular filtration rate (eGFR) using CG |
Salome: 2016 | Uganda; EA | Adults | CS | 953 (568) | TDF containing | 385 non TDF | ≥ 6 months. Median 9.3 years | Cross sectional | eGFR by CKI-Epi |
Bygrave: 2011 | Lesotho: SA | Adults | RC | 933 (566) | TDF containing | – | pts initiating TDF ART | 12 months | CrCl using CG |
Brennan: 2011 | South Africa: SA | Adults | RC | 890 (890) | TDF-containing | – | pts initiating TDF ART | 48 months | Nephrotoxicity defined as decline in kidney function from baseline secondary to a toxin. CrCl to estimate eGFR using CG |
Mwafongo: 2014 | Eastern and Southern Africa: | Women ≥ 13 years | RCT | 741 (741) | TDF containing | – | TDF naïve at baseline | 48 weeks median 2.3 years | CrCl or clinical renal diagnosis |
Zachor : 2016 | South Africa: SA | Adults | RC | 650 (650) | TDF containing | – | ART naïve | median 47 w | eGFR by CKD-EPI and confirmed by MDRD |
Mugomeri: 2014 | Lesotho: SA | Adults | RC | 485 (312) | TDF containing | 173 on other | > 6 months | > 6 months | eGFR by CG |
Zannou: 2015 | Benin; WA | Adults ≥ 16yrs | CS | 480 (62) |  | 2 NRTIs + 1 NNRTI. Those on 2nd line comprised 2 nucleosides RTIs + 1 PI | > 3 nths | Cross sectional | CrCl by CG |
Wantakisha: 2017 | Zambia: SA | Adults ≥ 15 years | CS | 445 (445) | TDF containing | − | 18 months | Cross sectional | CrCl |
Cournil: 2016 | Cameroon, Burkina Faso, senegal | Adults | RCT | 438 (306) | A: TDF + FTC + LPV/r (152); C: TDF + FTC + darunavir (DRV)/r (154) | B: ABC + ddI + LPV/r | 18 months on 2nd line | 18 months | eGFR (MDRD) |
De Beaudrap: 2010 | Senegal: WA | Adults | PC | 428 (40) | TDF-containing | Non-TDF | pts initiating on ART | 42Â months | eGFR using CG and MDRD |
Chadwick: 2015 | Ghana: WA | Adults | CSO | 330 (101) | TDF containing | Either AZT or D4T + NVP or EFV | ≥ 6 months, 20 months median time for TDF | Cross sectional | CrCl using CG, dipstick proteinuria, uPCR, uACR, uAPR, fractional phosphate and urate excretion. TD defined as having ≥ 2 of: fractional phosphate excretion > 18%, fractional urate excretion > 15%, normo-glycaemic glycosuria, proteinuria (uPCR > 20 mg/mmol) with uAPR < 0.4 |
Banda: 2010 | Zambia; adults | Adults | CS | 300 (52) | TDF containing | D4T (3), AZT (6), HIV- (158) | Not stated | Cross sectional | RD defined as rise of sCr to 1.5 × upper limit of normal i.e. ≥ 180 umol/L |
Orluwene: 2015 | Nigeria: WA | ≥ 16 years | PCC | 254 (100) | 100 TDF based | 102 Non-TDF. 52 Rx naïve | … | … | Urinary interleukin (Il)-18, eGFR by CG/MDRD/CKI-Epi |
Mpondo: 2014 | Tanzania; EA | Adults | RC | 238 (54) | 54 TDF | 184 | – | Median 2 yrs | eGFR by CG/MDRD |
Agbaji: 2011 | Nigeria; WA | Adults | OC | 186 (84) | TDF containing | Non TDF | ≥ 48 weeks | > 48 weeks | sCr and CrCl using CG |
Fritzsche: 2017 | Cameroon; WA | Adults | CS | 179 (119) | TDF containing | ART naïve pts | Mean period of 301 ± 193 days | Cross sectional | Urinary dipstick for proteinuria, sCr, eGFR using CKD-EPI. Kidney size and structure by ultrasound, renal echogenecity grading as described by Garko |
Seedat: 2017 | South Africa: SA | ≥ 15 years | PC | 175 (93) | 93 TDF exposed, | TDF unexposed | … | Duration of hospitalisation. | AKI by (KDIGO) 2012 Clinical Practice AKI Guideline. sCr eGFR by MDRD |
Kalemeera: 2016 | Namibia: SA | Adults | RC | 71 (71) | Second line TDF containing ART. | – | Mean 5.2 years on 1st line, 1.8 years on 2nd line | Cross sectional | CrCl. Renal function categories based on CG |
Gajee: 2016 | South Africa: SA | Adults 20–40 | RC partial prospective | 66 (66) | TDF containing | – | 12 months | 12 months | eGFR by CG at before TDF commencement and 12 months post-TDF commencement. |
Tewogbade: 2010 | Nigeria;WA | Adults | PC | 55 (19) | TDF + 3TC + EFV. or as truvada | D4T or AZT | initiating ART | 12 months | CrCl (MDRD), eGFR by CG |
Mulubwa: 2016 | South Africa: SA | Adult women | CS | 30 (30) | 300 mg TDF nocte | 30 HIV uninfected | – | Cross sectional | eGFR (MDRD), CrCl by CG |