3.8 Article

Tenofovir-induced distal renal tubular acidosis: A rare cause of recurrent hypokalaemic paralysis

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SAGE PUBLICATIONS LTD
DOI: 10.1177/14782715221103643

Keywords

hypokalaemic paralysis; renal tubular acidosis; tenofovir

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This case report describes a rare complication of tenofovir, which caused distal renal tubular acidosis presenting as hypokalemic paralysis. Regular follow-up of patients taking tenofovir with urine analysis and serum potassium is recommended to detect and treat this reversible complication earlier.
Tenofovir disoproxil fumarate was the first nucleotide analogue reverse transcriptase inhibitor to be approved for treatment of human immunodeficiency virus infection. It is a relatively safe drug but can present with nephrotoxicity. We report a case of 36-year-old male who presented with acute onset flaccid paraparesis. He was a diagnosed case of acquired immunodeficiency syndrome for 9 years ago and was on tenofovir-based antiretroviral therapy for last 6 months. As the patient had normal anion gap metabolic acidosis, hypokalaemia and urine pH > 5.5, distal renal tubular acidosis (RTA) was suspected. He improved dramatically within 24 h of hospitalisation after potassium correction to regain normal power. Tenofovir-induced distal RTA presenting as hypokalaemic paralysis is a very rare complication of tenofovir; hence, we are reporting this case. In addition, we suggest regular follow-up of patients taking tenofovir with urine analysis and serum potassium to detect this complication earlier as it is reversible.

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