Causes and consequences of hypokalemia in patients on tenofovir disoproxil fumarate

To determine the spectrum of clinical manifestations of hypokalemia associated with tenofovir, we reviewed all reports of grades 3/4 hypokalemia received by Gilead Sciences Department of Safety and Public Health. Of 32 cases identified in 2001-2006, 23 were attributed to proximal renal tubular dysfunction, and medically significant conditions attributable to hypokalemia occurred in four, which all improved with medical management. In none of the six fatal cases did hypokalemia appear to contribute to death.