Renal implication of nevirapine use in juvenile albino rats

Abstract

Elias Adikwu, Bokolo Bonsome

Background: Nevirapine (NVP) is excreted by the kidney, therefore, use in human immunodeficiency virus exposed neonates could be of safety concern due to decreased renal function associated with the neonatal period. This study, therefore, investigated the nephrotoxic profile of NVP in juvenile albino rats. Materials and Methods: Juvenile albino rats used for this study were divided into seven groups A-G of five rats each. Rats in groups A and B were treated with water and normal saline as placebo and solvent control, respectively. Rats in groups C-G were treated orally with 4-32 mg/kg/day of NVP for 14 days, respectively including a recovery group. At the end of drug administration, rats were weighed and sacrificed. Blood was collected; serum extracted and evaluated for creatinine (Cr), urea (U), uric acid (UA), albumin (Ab), total protein (TP), and electrolytes (K+, Na+, Cland HCO3 - ). Kidneys were harvested, weighed and evaluated for superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), malondialdehyde (MDA) levels, and histological changes. Results: The body, absolute, relative kidney weights, and serum electrolytes were not significantly (P > 0.05) altered in the NVP treated rats in comparison to placebo control. However, serum levels of Ab and TP were decreased, whereas Cr, U, UA were increased significantly (P < 0.05) and in a dose-dependent manner in NVP-treated rats. Kidney levels of MDA were increased, whereas SOD, CAT, and GSH levels were decreased significantly (P < 0.05) and in a dose-dependent manner in NVP-treated rats. Kidneys of NVP-treated rats showed dose-dependent tubular necrosis. However, NVP-induced changes in all evaluated parameters were restored in the recovery group. Conclusion: This study observed dose-dependent and reversible renal toxicity in NVP treated juvenile albino rats. The use of NVP in neonates may be safe; however, neonatal renal function assessment is advice before and with NVP use.