{
  "abstract": "Background: The total urinary protein-to-creatinine ratio (PCr) measures proteinuria but does not establish tubular injury or its recovery. Methods: We examined PCr changes after switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) in a single-centre retrospective cohort of 364 adults with human immunodeficiency virus (HIV) infection. Paired PCr values were available for 159 patients (43.7%). The primary descriptive endpoint was a PCr reduction below 20%, an operational, nonvalidated threshold. Analyses comprised paired rank-based comparisons, baseline-adjusted regression, threshold and influence sensitivity analyses, and nested cross-validation of ridge logistic regression using three predictor sets. Results: The median paired PCr change was -4.0 mg/g (interquartile range -41.5 to 11.5; signed-rank Benjamini-Hochberg-adjusted q = 0.0098); 99/159 patients (62.3%) had a reduction below 20%. Baseline log(1 + PCr) was positively associated with post-switch log(1 + PCr), while its coefficient in the corresponding change model was exactly one unit lower, illustrating mathematical coupling. The cross-validated area under the curve was 0.709 for baseline PCr alone, 0.475 for the other covariates, and 0.701 for all predictors. Conclusions: PCr changes were heterogeneous, and additional covariates did not improve discrimination over the baseline PCr alone. Missing outcomes, unavailable specimen dates, the absence of tubular-specific biomarkers and the uncontrolled design preclude conclusions about irreversible tubular injury, causal treatment effects or clinical prediction utility.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy.",
    "Tumor Immunology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Corso Tukory 211, 90134 Palermo, Italy.",
    "Legal Medicine Unit, University Hospital \"Paolo Giaccone\", Via del Vespro 129, 90127 Palermo, Italy.",
    "Infectious and Tropical Diseases Unit, University Hospital \"Paolo Giaccone\", Via del Vespro 129, 90127 Palermo, Italy.",
    "Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Tommaso D'Anna",
      "orcid": "0009-0000-5162-7151"
    },
    {
      "affs": [
        3
      ],
      "name": "Marcello Trizzino",
      "orcid": "0000-0002-8105-5139"
    },
    {
      "affs": [
        1
      ],
      "name": "Beatrice Belmonte",
      "orcid": "0000-0001-9668-0925"
    },
    {
      "affs": [
        3
      ],
      "name": "Claudia Gioè"
    },
    {
      "affs": [
        0
      ],
      "name": "Augusto Orlandi",
      "orcid": "0000-0001-7202-5854"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Stefania Zerbo",
      "orcid": "0000-0003-1101-0864"
    },
    {
      "affs": [
        4
      ],
      "name": "Andrea Cicero"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Antonina Argo",
      "orcid": "0000-0002-9964-0184"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Antonio Cascio",
      "orcid": "0000-0002-1992-1796"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a93fp09tg36re.bib",
  "cited_by": 0,
  "doi": "10.3390/diseases14100353",
  "fulltext_url": "https://europepmc.org/articles/PMC13703067",
  "id": "a93fp09tg36re",
  "issns": [
    "2079-9721"
  ],
  "landing_url": "https://europepmc.org/article/MED/42929980",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|HIV/AIDS drug development and treatment"
    ]
  ],
  "openalex": "W7214175258",
  "pdf_url": "https://europepmc.org/articles/PMC13703067?pdf=render",
  "pmcid": "PMC13703067",
  "pmid": "42929980",
  "published": "2026-09-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a93fp09tg36re.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42929980",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42929980"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|HIV/AIDS drug development and treatment",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Assessing Renal Outcomes After Switching from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in People with HIV: Proteinuria Changes and Limits of Causal Attribution.",
  "title_text": "Assessing Renal Outcomes After Switching from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in People with HIV: Proteinuria Changes and Limits of Causal Attribution.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/a93fp09tg36re",
  "venue": "Diseases (Basel, Switzerland)",
  "versions": []
}