Kind to Kidneys ?

[budndallastx]

Well I have been on meds now for six weeks and have started my third combination...

First, I was on Sustiva and Epzicom but had to stop due to my reaction to the Abacavir.  The doctor then put me on Sustiva and Truvada but I have decreased kidney function so now I am on Sustiva and Combivir (AZT/3TC).
The question I have is what combinations are "kind" to the kidneys?  Also, starting on AZT scares the hell out of me because of the horror stories I have read.  What can I expect on the Sustiva/Combivir regimen considering I have not had any effects from the Sustiva other than the initial two days taking it ?

Thanks in advance for any replies!

[yowsaa]

Hey budndallas,

combivir/sustiva worked well for me. If it's the lipo your afraid of, dont be. Not everyone gets that side effect and you can monitor yourself and tell doc also. Takes years to start getting it. By that time who knows what knew pills will fall out of the pipeline. If this is what troubles you, inbox me and i'll let you know from my own expierence what to watch yourself for.

Your pretty likely to get some kind of side effect from any meds, some mild, some not. Combivir gave me the sh*ts , had about 2 minute warning to find a toilet. Yeah that sucked, but just adapted to it.

start taking a multivitamin also.
Whatever the sides are, I figure it's a small price to pay compared to the alternative.

p.s. Can u hook me up with a dallas cowboy cheerleader 

[penguin]

how decreased, is decreased?

Most hiv meds are cleared by the liver - some though, ie nukes like tenofovir (& indinavir, an older PI) are cleared more by the kidneys, which can exacerbate pre-existing problems - hence, importance of regular monitoring.
If necessary, there are reduced dosage guidelines for this class of drugs, based on creatinine clearance & for some, weight too.  Not really an issue unless your cr/cl is below 50 ml/min though. Me, with proper dodgy kidneys, did as little as twice a week dosing of tenofovir at various points - got a bit complicated, the remembering when to take it sometimes.

PI’s & non nukes (like your sustiva) don’t require any dosage adjustments, and generally don’t cause a problem with renal function.

kate

[budndallastx]

My creatinine levels usually fluxuate between 1.5-1.7 with a GFR of 44-48 ml/min.  I have had kidney issues since 2001 but have been stable since getting on Avapro (blood pressure med).  I also have a diet heavy on vegetables which helps since the average American consumes way too much protein per day. 

[newt]

You can work out your creatine clearance rate from serum creatine, age and weight and sex here

For Viread(or Truvada) the prescribing info says no dose adhustment is  needed unless this falls below 50mL/min

Seealso: Dosing of Antiretroviral Drugs in Adults with Renal Insufficiency and Hemodialysis

- matt