富马酸替诺福韦二吡呋酯致范科尼综合征伴肾性尿崩症1例  

Tenofovir disoproxil fumarate induced Fanconi syndrome with renal diabetes insipidus:a case report

作　　者：黄妮娅 张彩琼 张志清[1] HUANG Niya;ZHANG Caiqiong;ZHANG Zhiqing(Department of Pharmacy,First People's Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology,Yunnan Kunming 650032,China;Department of Pharmacy,Puer People's Hospital,Yunnan Puer 665099,China)

机构地区：[1]云南省第一人民医院/昆明理工大学附属医院药学部,云南昆明650032 [2]普洱市人民医院药学部,云南普洱665099

出　　处：《中国医院药学杂志》2024年第22期2670-2672,共3页Chinese Journal of Hospital Pharmacy

摘　　要：1例HIV感染患者在接受富马酸替诺福韦二吡呋酯抗病毒治疗后,出现反复四肢无力、低钾血症伴口干、多尿。入院检查提示代谢性酸中毒、低钾、低磷、低尿酸血症、肾性糖尿等近端肾小管功能异常,及肾功能下降。监测尿量大于3 000 mL·d^(–1),尿比重降低。肾脏病理结果显示肾小管病变。诊断为范科尼综合征,肾性尿崩症。经停用替诺福韦及补钾、纠正酸碱平衡等对症支持治疗后患者症状及指标好转。接受替诺福韦治疗的患者应加强用药监护,尽早识别肾损害的发生,及时采取干预措施。A patient with HIV infection developed recur-rent limb weakness,hypokalemia,associated with mouth dry-ness,and polyuria after receiving tenofovir disoproxil fuma-rate antiviral therapy.The laboratory examinations showed proximal renal tubular dysfunction such as metabolic acidosis,hypokalemia,hypophosphatemia,hypouricemia,renal glycos-uria,and renal function decline.Urinalysis revealed urine spe-cific gravity reduction and urine volume was recorded over 3000 mL·d^(-1).Combined with renal pathological results,renal tubular lesions were identified.The patient was diag-nosed with Fanconi syndrome and renal diabetes insipidus and tenofovir-induced nephrotoxicity was considered.The patient's symptoms and laboratory indicators were improved after drug withdrawal,potassium supplementation,and cor-rection of acid-base balance.Patients receiving tenofovir must be monitored closely for early signs of renal damage to ensure the safety of drug use in clinic.

关 键 词：富马酸替诺福韦二吡呋酯 范科尼综合征 肾性尿崩症 肾功能不全 

分 类 号：R282[医药卫生—中药学]