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Author Topic: Tenofovir, muscle mass and kidney function  (Read 3879 times)

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Offline skecherkid

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Tenofovir, muscle mass and kidney function
« on: April 03, 2009, 11:21:08 AM »
Has anyone had experience with kidney problems after going on Truvada / tenofovir?  I have only been on it for three months but my doctor is worried about my creatinine level.  It is elevated but I looked back at labs I had several years ago and they were also elevated.  My level seems to bounce between 1.3 and 1.7.  Both of which are above the level a male "should" be at.

But I did some googling and read that because creatinine level depends in some part on amount of muscle mass and I am quite muscular.  I also include whey powders in my diet at least once a day.   

Does anyone have any experience with this?  Is elevated creatinine bad in itself or may my elevated level just mean I have more muscle mass than typical?  I don't want to have to switch from truvada if not really necessary.

Offline Miss Philicia

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Re: Tenofovir, muscle mass and kidney function
« Reply #1 on: April 03, 2009, 12:02:54 PM »

Viread can be problematic for HIV-positive people who have a history of kidney problems (renal impairment). If you have a history of kidney problems, your doctor will need to order a simple laboratory test to measure your "creatinine clearance"óthe rate your kidneys remove this protein produced by muscles from the bloodstream. Depending on the results of this test, your Viread dose may need to be decreased. It is always important to be careful if using Viread in combination with Vistide (cidofovir), Cytovene (ganciclovir), and Valcyte (valganciclovir), three treatments for CMV that can also cause kidney problems.

What's odd is that if your levels were high before going on truvada then why didn't your doctor address this at that time?  Did you point out this from your older labs, or did you just notice it?  I'm also assuming that you work out a lot, so you know if you take creatine supplements (though you didn't mention it) you should tell your doctor.  Don't be shy about doing so. I used to take all of that stuff myself when I first went on Truvada (whey, creatine, etc.) but never had an issue on my labs so can't tell you much more.

Keep me posted with what you find out because I'd enjoy knowing the info.
"Iíve slept with enough men to know that Iím not gay"

Offline skecherkid

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Re: Tenofovir, muscle mass and kidney function
« Reply #2 on: April 03, 2009, 12:12:55 PM »
I'll keep you posted.  My doctor was not very worried at all about the old labs at the time.  One test showed 1.6 and the next 1.3 and the urine test showed no protein. 

But at that time although I was HIV poz I was not one meds.  So now, she is somewhat worried about the Truvada.   Anyway, she has me set for a one-week no supplements diet and then a new lab test for blood creatinine and urine proteins.


Offline Peter Staley

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Re: Tenofovir, muscle mass and kidney function
« Reply #3 on: April 04, 2009, 09:00:49 AM »
I do remember reading somewhere that a high protein diet (or supplements) can raise one's creatinine levels.  It could be the protein shakes.

Offline bocker3

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Re: Tenofovir, muscle mass and kidney function
« Reply #4 on: April 04, 2009, 10:22:11 PM »
A couple of questions to consider?
When you say your creatinine levels are elevated since starting Truvada -- are the higher than they were before you started or still coming in at your previous 1.3 - 1.7 range?
If she is concerned, about the creatinine (now, anyway -- as she didn't seem concerned before) -- is she ordering anything else -- like the creatinine clearance test mentioned in Miss Philicia's post?

I think it would be good to get a little more evidence of kidney "issues" before deciding to change meds -- unless of course your current creatinine levels are markedly higher since starting the Truvada.
At the end of the day, if your kidneys are being stressed (either before or after starting this med), why push them even further when there are other options (I am assuming that there are other options available to you).

Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2015 969/28% <20

Offline skecherkid

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Re: Tenofovir, muscle mass and kidney function - switching to Epzicom now
« Reply #5 on: April 28, 2009, 11:33:26 PM »
I'm going to be switching from the Truvada to Epzicom in a week.  My doctor still did not like the creatinine level even after I eliminated the protein supplements from my diet.  And the test for the abacavir showed I should not be hypersensitive. 

Anyone have any experience with such a switch?  I figure I will just take it with dinner along with the reyataz and norvir like I always do with the Truvada. 

Thanks in advance!

Offline newt

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Re: Tenofovir, muscle mass and kidney function
« Reply #6 on: April 29, 2009, 07:59:14 PM »
Apart from the hypersensitivity its easy (generally) but it does double your risk of cardiovascular disease over 10 years. Get a baseline assessment for CV health  -- and don't fret if this is less than 10% - this is one of those bum combo choices: heart or kidneys...

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

Offline skecherkid

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Re: Tenofovir, muscle mass and kidney function
« Reply #7 on: May 05, 2009, 01:52:38 PM »
Thanks all!  I did get a set of cardiovascular blood tests as well as the others, and that looks good.  Low cholesterol, and the lipids / triglycerides are good.  I didn't know the epzicom raised the chances of heart disease - good to know.

I start the epzicom tonight!

Offline LTSurviver

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Re: Tenofovir, muscle mass and kidney function
« Reply #8 on: May 19, 2009, 01:57:09 PM »
My Doctor and I just went through this a couple months ago.  He was ready to stop my Truvada untl we looked deeper and I changed what I did 24 hours before having my blood drawn.

Three things are causing your results:

Higher muscle mass means higher creatinine.  Large body builders can average a creatinine level of 2.0

Eating more than 8 ozs of red meat in the 24 hours before the test also will cause the test to be higher.  Also, supliments containing Creatine will also cause the number to go higher.

And MOST importantly:  Lifting weights within 48 hours before the tests will make your creatinine number go through the roof.  I lifted weights, ran, and ate a high meat meal one day before getting my blood drawn and my creatinine number was 2.3.

Once we figured out was was going on, my creatinine level is at 1.2 -1.4 when tested.  Normal for a bodybuilder.

So, 24 hours before the test eat little/no meat, take no creatine, lift no weights, lay off any cardio and get plenty of water.


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