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Author Topic: Changed Atripla to Epzicom isentress Because of kidneys  (Read 3544 times)

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Offline peteb

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Changed Atripla to Epzicom isentress Because of kidneys
« on: August 26, 2010, 01:00:07 PM »
I had to change meds cuz my Doc said it was making damaging my kidneys has anyone had this problem with Atripla

Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #1 on: August 26, 2010, 01:45:22 PM »
I had to change meds cuz my Doc said it was making damaging my kidneys has anyone had this problem with Atripla

This can happen with tenofovir which is 1/3 of Atripla. It's also part of Truvada, which is the reason he put you on Epzicom.

The great majority of people with HIV take tenofovir, mainly as part of Atripla or as part of Truvada. Most people are able to take it without it causing any appreciable kidney damage but it's important to monitor the situation, which is what blood tests are for, in order to make a change if necessary.

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #2 on: August 26, 2010, 01:46:53 PM »
thanks

Offline skeebo1969

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #3 on: August 26, 2010, 01:47:33 PM »

    When I first started Atripla it did the same thing to me, but I was also on Bactrim at the time.  Once my Cd4's got above 200 and the Bactrim was discontinued my labs indicated everything had returned back to normal.  I haven't heard many members having to switch because of this however, I can remember  researching back then and read that Atripla can cause kidney and renal failure.   I eventually had to switch anyways due to other side-effects.

   In the end, your doctor knows best.
I despise the song Love is in the Air, you should too.

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #4 on: August 26, 2010, 02:21:08 PM »
thanks sceebo

Granny60

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #5 on: August 26, 2010, 04:02:31 PM »
Yes. Atripla kicked the shit out of my VL and  gave me a 160 point jump inn CD4 in the first month to 175, but shut down my kidneys.  Had to make the change too.   Hubby is still on Atripla.

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #6 on: August 26, 2010, 05:11:22 PM »
what meds are u on now
and I hope it helps
Pete

Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #7 on: August 26, 2010, 06:48:39 PM »
This is the most recent news on tenofovir and kidney function:

http://www.eatg.org/eatg/Global-HIV-News/Treatment/Tenofovir-treatment-impairs-kidney-function-but-clinical-significance-limited

Isentress and Epzicom are very good. I'm on Isentress/Truvada and doing great. Isentress is likely to be approved for once daily dosing; there are some people already taking it that way.

Offline ElZorro

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #8 on: August 26, 2010, 08:05:57 PM »
Peteb, et. al.

How long were you on Atripla before the kidney damage was noticed and, is it permanent damage?

Asking because I've been on it now for almost 9 months.

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #9 on: August 26, 2010, 08:28:58 PM »
I have been on it since Feb of this year so I had to switch 2 weeks ago
My doc told me it was minor damage so hopefully it does not progress
ur doc should be checking ur urine that will let u know

Offline ElZorro

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #10 on: August 26, 2010, 08:32:36 PM »
thanks for the update. Yep, my docs check it and my mom is a nurse who insists on glossing over all of the results after the docs are done.  :P

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #11 on: August 26, 2010, 08:33:33 PM »
thats good its nice to have someone look after u
:)

Offline ElZorro

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #12 on: August 26, 2010, 08:40:55 PM »
I'd be interested in knowing how well Atripla worked for you and how you like the meds after you've been on them for awhile.

I'm doing well on Atripla but I do believe that is affecting my CNS. I notice that I'm "down" much more than I ever was pre-HIV and (while it would never happen), I find myself having "foolish" thoughts about a permanent solution to HIV that would preclude ever needing meds again  :-\  Those thoughts usually come when I'm feeling stressed or lonely, so I just try to stay busy and distracted.

I've talked to my doc about it and rejected the notion of taking anti-depressants at this time, though. I like the once a day dosing and am finding adherence a piece of cake.  Plus, I have stocked up an extra 3 bottles of Atripla...lol 8)


Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #13 on: August 26, 2010, 08:49:00 PM »

ur doc should be checking ur urine that will let u know

Blood tests can also be used to diagnose kidney function; it's the part of the lab report called BUN, creatinine and uric acid.

You can use this site to figure out your rate of creatinine clearance:

http://clinicalculator.com/english/nephrology/cockroft/cc.htm

Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion which can be blocked by cimetidine. Alternatively, over estimation by older serum creatinine methods resulted in an under-estimation of creatinine clearance which provided a less biased estimate of GFR[1]. Both GFR and CCr may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result (eGFR and eCCr).

LINK:

http://en.wikipedia.org/wiki/Renal_function

Granny60

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #14 on: August 26, 2010, 11:45:50 PM »
I was on it for  only a month and spent a week in the hospital trying to get my kidneys going again, biopsies and all kinds of crap,  but did recover.  They said for most people it is a gradual thing and most do recover most of their function after quiting Atripla like I now have.  Some people it screws with,  some it doesn't. That is why Labs are important.

Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #15 on: August 27, 2010, 12:16:21 AM »
As Dr. Gallant has said, "Kidney damage caused by tenofovir is usually reversible, provided you don't wait too long."

The link below is an excellent overview on tenofovir and kidney function from Dr. Gallant:

http://www.hopkins-aids.edu/q_a/patient/antiretroviral_therapy/antiretroviral_agents/nucleoside_and_nucleotide_reverse_transcriptase_inhibit/tenofovir_and_kidney_function.html?contentInstanceId=488399
« Last Edit: August 27, 2010, 10:14:12 AM by Inchlingblue »

Offline Miss Philicia

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #16 on: August 27, 2010, 12:57:51 AM »
Something to think about for all of the people that are wanting to stretch their routine HIV lab tests to once annually, n'est ce pas?
"Iíve slept with enough men to know that Iím not gay"

Offline randym431

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #17 on: August 28, 2010, 09:07:47 AM »
I hate to be the wicked witch of the west here... but...
I started epzicom and sustiva in 2005, and lately my ID doc says
studies (he names the study but I did not write it down), but studies
show the stuff in epzicom can cause heart damage long term.
He wanted me (last visit) to think hard about switching off epzicom.
He did not say I myself had heart issues, but he acted like it was too risky
to remain long term on epzicom.
They originally started me on epzicom cause I have one kidney that is
a "sponge kidney" (produces kidney stones). So back then in 2005 they wanted
me to go on epzicom/sustiva rather than the more popular treatment duo.

Ask your doc about the studies showing higher heart damage in long term epzicom patients.
As for me... I'm prefer to stay with epzicom cause its worked so well on the VL and my cd4 has been stable.
If its not one thing... its another... 
« Last Edit: August 28, 2010, 09:10:22 AM by randym431 »

Offline Hellraiser

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #18 on: August 28, 2010, 09:33:30 AM »
I hate to be the wicked witch of the west here... but...
I started epzicom and sustiva in 2005, and lately my ID doc says
studies (he names the study but I did not write it down), but studies
show the stuff in epzicom can cause heart damage long term.
He wanted me (last visit) to think hard about switching off epzicom.
He did not say I myself had heart issues, but he acted like it was too risky
to remain long term on epzicom.
They originally started me on epzicom cause I have one kidney that is
a "sponge kidney" (produces kidney stones). So back then in 2005 they wanted
me to go on epzicom/sustiva rather than the more popular treatment duo.

Ask your doc about the studies showing higher heart damage in long term epzicom patients.
As for me... I'm prefer to stay with epzicom cause its worked so well on the VL and my cd4 has been stable.
If its not one thing... its another... 

Abacavir is what causes the heart damage.

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #19 on: August 28, 2010, 10:55:53 AM »
thanks Randy thats all i need is heart trouble'I seem to be gettin it all :(

Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #20 on: August 28, 2010, 10:57:30 AM »
There have been studies that saw no link between abacavir and heart issues, others that have. It has not been definitively answered. I think the concern is for those who have a family history of heart problems or have other risk factors (similar to how to approach tenofovir and kidneys).

Of course, nuke-sparing regimens are also another way to go for those who can do that. There should be more options for combinations in the near future.

Offline ElZorro

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #21 on: August 29, 2010, 02:52:02 AM »
Something to think about for all of the people that are wanting to stretch their routine HIV lab tests to once annually, n'est ce pas?

Guilty as charged...good point. I've been complaining to my Dr about the quarterly checkups and pressing for bi-annual or annual....you're right  :P

Offline tednlou2

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #22 on: August 30, 2010, 02:33:40 AM »
Blood tests can also be used to diagnose kidney function; it's the part of the lab report called BUN, creatinine and uric acid.

You can use this site to figure out your rate of creatinine clearance:

http://clinicalculator.com/english/nephrology/cockroft/cc.htm

Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion which can be blocked by cimetidine. Alternatively, over estimation by older serum creatinine methods resulted in an under-estimation of creatinine clearance which provided a less biased estimate of GFR[1]. Both GFR and CCr may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result (eGFR and eCCr).

LINK:

http://en.wikipedia.org/wiki/Renal_function

Are blood tests for kidney function very accurate?  I'm sure they are or they wouldn't do them.  I guess I meant very, very accurate.  I've heard some say they believe BUN and Creatinine can be showing all is well when it is not.  I'm not sure whether they are correct or mistaken.  I'll read posts/blogs where people say they have smelly urine and back pain and think their kidneys are messed up.  I'm sure smelly urine is normal depending on diet and I remember Dr. Gallant saying tenofovir kidney issues would not cause back pain.   

Offline Inchlingblue

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #23 on: August 30, 2010, 10:48:24 AM »
Are blood tests for kidney function very accurate?  I'm sure they are or they wouldn't do them.  I guess I meant very, very accurate.  I've heard some say they believe BUN and Creatinine can be showing all is well when it is not.  I'm not sure whether they are correct or mistaken.  I'll read posts/blogs where people say they have smelly urine and back pain and think their kidneys are messed up.  I'm sure smelly urine is normal depending on diet and I remember Dr. Gallant saying tenofovir kidney issues would not cause back pain.   

According to Gallant:

A baseline creatinine should be performed on anyone, regardless of whether they'll be using tenofovir. A number of nucleoside analogs have to be given at reduced doses in people with kidney disease.

A normal creatinine is the only test you need, but I still recommend that a creatinine clearance be calculated if the creatinine is in the upper end of the normal range.


LINK:

http://www.hopkins-aids.edu/q_a/patient/antiretroviral_therapy/antiretroviral_agents/nucleoside_and_nucleotide_reverse_transcriptase_inhibit/tenofovir_and_kidney_function.html?contentInstanceId=488399

Offline Miss Philicia

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #24 on: August 30, 2010, 01:30:54 PM »
Yeah, that's always been part of my routine lab work.  In addition (and I could be wrong in the intent) my doctor gets me up on the examining table, and I pull up my shirt slightly while he listens to my heart and lungs, but then he also does this "thumping" thing around where my kidneys are. I assume if you're beginning to have problems there would be a dull pain developing there, or maybe it's at the bottom of your back.  But I just assumed it was something like that, as I've also had previous HIV doctors do similar things.
"Iíve slept with enough men to know that Iím not gay"

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #25 on: August 30, 2010, 02:08:37 PM »
they thump me on the right sight kinda in the back
makes me wanna beat the shit out oh her JK it does hurt

Offline peteb

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Re: Changed Atripla to Epzicom isentress Because of kidneys
« Reply #26 on: October 06, 2010, 06:11:50 PM »
OH YEAH
finally UD will post state numbers in awhile

 


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