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Author Topic: Kidney function high, Doc told me to stop Truvada. Options???  (Read 2003 times)

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Dan J.

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Kidney function high, Doc told me to stop Truvada. Options???
« on: September 01, 2006, 10:11:14 AM »
My current drug combo is Truvada, Reyataz & Norvir. My kidney fuction was high yesterday. Doc thinks it is because of Truvada. He wants me to immediatly stop taking the Truvada and start either Combivir/Ziagen/Reyataz/Norvir or Trizivir/Zerit/Reyataz/Norvir. Isn't there a simpler drug combination?  I know I don't drink nearly as much water as I should through out the day. If  I started drinking more would that make a difference?
I do not want to take combivir/ziagen. I took ziagen before and had an allergic reaction to it & I when I took Zerit before the neuropathy side effects caused me some problems. Really need a once a day combo, something that is easy to adhear to... Suggestions???

Dan J.

 ???

Offline penguin

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Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #1 on: September 01, 2006, 10:42:11 AM »
Dan,

breathe.

when you say your "kidney function was high yesterday"..you mean your creatinine clearance?and how high is high? is this something new, ie have you ever had kidney problems in the past?
Kidneys, they can struggle a bit form time to time,lots of reasons..isn't necessarily cause for panic and med changes, perhaps just some more investigations..

if there is a problem, with the kidneys,related to meds, it is probably the viread part of the truvada. I have impaired kidney function, yet still take truvada, i just take it as the individual drugs,and the viread is dosed lower. so that might be an option to talk about with your dr.
Your dr's suggestions would have you on 3-4 NRTIs, + a boosted PI - is there a reason for this, ie resistance? if your current combo is working, just wondered if this would be necessary..avoiding zerit, if at all possible, would be good, ditto azt if you can.. & putting you back on ziagen, sounds downright daft, if you were allergic to it?
another option, might be worth talking to him about using 2  boosted PIs + the FTC part of the truvada you currently take..

Main thing,i think, is to work out what is happening with your kidneys, whether this is a one off, or has some other cause, before jumping into changing combo drugs straight away?

hope that helps, a bit

Kate
ps, yes, drink more, clear fluids (sadly, they don't count vodka  :) )
« Last Edit: September 01, 2006, 10:50:58 AM by penguin »

Offline allanq

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Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #2 on: September 01, 2006, 11:31:20 AM »
Dan,
I recently had to stop taking Viread because of high creatinine levels (2.2 vs. normal of 1.3). However, the decision to stop was based on three successive readings that were high, not just one. After stopping the Viread, my creatinine levels went down some, but not enough. I then stopped Tricor (triglyceride med), and my kidney function returned to normal.

Also, one of the options offered to you included Trizivir and Zerit. Zerit is notorious for causing lipodystrophy and neuropathy, and AZT is also associated with wasting.

I agree with Kate that 3-4 NRTIs just doesn't sound right, especially when one of them is Zerit.  And going on abacavir (Ziagen) is very dangerous. There are very specific warnings about NOT going back on Ziagen if you had an allergic reaction the first time.

Can you see another doctor for a second opinion? Based on what you've said, I don't have a lot of confidence in your doctor.

Allan
Top (Breakfast): Prezista, Norvir, Isentress, Zoloft (2), Glyburide (2), Aspirin
Bottom right (Dinner): Prezista, Norvir, Isentress
Bottom left (Bedtime): Sustiva, Trazodone (2), Lipitor, Septra (no longer taking this)
Center: Alprazolam (Xanax)
Not shown: various vitamins & supplements

Dan J.

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Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #3 on: September 01, 2006, 11:58:14 AM »
I just left the doctors office. He changed my meds to:

Zerit 20 mg 1 tablet 2X Daily
Epivir 150 mg 1 tablet 2X Daily
Reyataz 150 mg 2 daily
Norvir 100 mg 1 daily

My labs from yesterday were:

Triglycerides 156 High
Glucocose 101 High
Creatinine 1.7 High
BUN/Creatinine Ratio 9
Sodium 140
Potassium 4.2
Chloride 105
Carbon Dioxide 27
Calcium 8.9
Protien Total 6.8
Albumin 4.4
Globulin 2.4
Albumin/Globulin Ratio 1.8
Billirubin, Total 2.9 High
Alkaline Phosphatase 93
AST 16
ALT 16
Lymphocyte Subset Panel 4 Pending
White Blood Cell Count 5.8
Red Blood Cell Count 4.23
Hemoglobin 14.2
Hematocrit 40.7
MCV 96.2
MCH 33.6 High
MCHC 34.9
RDW 12.6
Platelet Count 207
Absolute Neutrophils 3057
Absolute Lymphocytes 2227
Absolute Monocytes 365

There aren't that many med options left for me unless I go Fuzeon/Presista because I am either allergic or have resistance to other drug combos. Doc mentioned the possibility of taking the Kaletra tablet 4 pills twice a day but he said it wasn't a proven therapy & I was affraid of that so I went with  the zerit, epivir, reyataz, norvir "cocktail."  I had bad neuropathy problems while taking zerit before & I am sure those will return.

I'm frustrated to say the least...

Dan J.
« Last Edit: September 01, 2006, 12:10:51 PM by Dan J. »

Offline penguin

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Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #4 on: September 01, 2006, 02:58:54 PM »
dan, if you are not happy with this, & i can see why you wouldn't be, you need to talk to your dr &/or request a second opinion.

creatinine level range is 0.7-1.2, but that is a guide, some people will have naturally higher or lower levels. How does this compare with results from past labs?
one result (and i assume it is just one, not something that has been a problem before?) of 1.7, without further investigation or confirmation, does not (imho) call for urgent med-changing situation.especially to meds which you are not happy about taking, and worry may cause worsening of other issues.

Kate



Dan J.

  • Guest
Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #5 on: September 01, 2006, 03:25:36 PM »
I assume my Dr. looked at past labs  & he had more blood drawn today . The results from todays blood work will be back on Tuesday.

Dr. G was very adamant about me dropping Truvada. I asked him if drinking more water thru the day would help. He said no so here we go changing meds again...

DAMN-IT!


Dan J.


Offline lydgate

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  • Virgin, can't drive
Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #6 on: September 08, 2006, 08:47:46 AM »
Hey Dan... So are the results back? What have you and the doc decided? I'm sorry that you have to go through this whole shebang again -- fiddling and tinkering with the med combo until you find the optimal cocktail. Thinking of you matey.

Jay  :-*
Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

George Eliot, Middlemarch, final paragraph

Offline newt

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Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #7 on: September 08, 2006, 09:07:15 AM »
The correct diagnostic test for tenofovir (the half of Truvada that affects the kidneys) and kidneys is creatine clearance, not serum creatine levels.

Tenofovir should not be taken every day by people with a creatine clearance of  under 50 milliliters per minute (mL/min). Your doctor can order laboratory tests to measure creatine clearance.

The prescribing info for tenofovir indicates you may alter the dose interval as follows:

Creatine clearance 39-50 mL/min - take every 2 days
Creatine clearance 10-29 mL/min - take twice a week

However, alternate days/2 x week dosing may not be good for adherence, switching may be better. 

Personally I'd want a creatine clearance test before switching. High creatine can have several causes.

- matt
"The object is to be a well patient, not a good patient"

Offline Moffie65

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  • Posts: 1,755
  • Living POZ since 1983
Re: Kidney function high, Doc told me to stop Truvada. Options???
« Reply #8 on: September 08, 2006, 10:15:35 AM »
DAN J.,

I don't give a f**k what your doctor says, he isn't taking this poison, and he isn't "living with the virus".  Just remember, doctors in the United States, only have about 8 hours of nutrition training in the whole of their schooling.  I don't know if that number has changed from the '90s but back then this was true.  Are we to believe anything about nutrition from a doctor then?  I say screw the lot of them.  We are a really incredible machine, and nutrition is the fuel that makes the machine work; how then is it possible that in the most advanced country on the globe, (according to most Americans, tee hee) we are to take the word of a doctor on nutrition when they don't give a damn about it in school?

I know I don't drink nearly as much water as I should through out the day. If  I started drinking more would that make a difference?.................I asked him if drinking more water thru the day would help. He said no so here we go changing meds again... ..................................Options???.

All I have to say is DUH!,,  Of course it will make a difference.  Damn, you know the answer to this one, so please start to drink a minimum of one half gallon of water each day, and then try to make it to one gallon.  Shit man, your body is 97% water, and if we don't keep the level of water in our systems circulating and replenishing, then the side effects from HAART are certainly going to be worse than better. 

On the questions of options........  Yes, there are loads of them. 

One is to draw a nice hot bath, light some candles and place them in and around the bathroom, gather up some music that relaxes you, find a book that is uplifting, grab a huge mug of ice cold water and a pitcher full of same and settle in for a nice long soak in the tub.  Let the nerves relax, let your heart think of things that will make you happy, and PLEASE don't obsess about this particular thing.  I know, preaching to the choir here, but hell Dan, you gotta take care of you sometime, and now is the perfect time.  Other things will wait, and be there when you are finished, but now, you need to help you and this is one "OPTION".

Love ya man, so please keep yourself well and work through this one.  Please drink more water, your body is screaming for it.

IN Love.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

 


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