Language Barrier in trying to understand my lab results
Apr 10, 2011
I'm living in a foreign country, tested positive about three months ago. I am dealing with language issues with my doctors and I am a little concerned about what sounds like might be kidney disease and how bad it actually is. Because of communication problems, its difficult to gauge exactly what is going on and how serious it is. I've been on a roller coaster ride of stressing over being positive, learning I was positive, learning I might be very lucky in that I am a slow progressor, and then learning I might have kidney disease. Any insight you could provide would be very helpful!
My initial test was CD4 460 and a very low viral load of 450. I believe I contacted HIV about a year and a half ago. My doctor said I might be a very slow progressor. However there was a reading of +3 on urine protein and +1 occult blood.
My second labs came back with CD4 of 695 and viral load of 4000. A echogram showed nothing wrong with my kidneys. But some further tests showed urine creatinine of 203.1 mg/dl and a urine protein level of 389.8 mg/dl. Most of my labs are in a language I can't read so I'm having problems piecing things together enough to research them. My doctor explained something along the lines of PRO/CRE equals an estimated daily protein level of 1.9 for me, wheras 0.1 is normal. This sounds pretty serious to me. Is it?
I was sent over to a kidney specialist, and he thinks high blood pressure is the culprit. I've had high blood pressure for a while but didn't realize it. He started me on hypertention meds,and my blood pressure is slowly coming down.
However, I am so worried about what these kidney labs mean and if I can get it under control, what will it mean for me when I have to start medication. Is my liver so damaged that I'm going to have a very difficult time with HIV meds?
I have my next appointment in a month where some more detailed lab results will come back. In the meantime, I really need to evaluate whether this is serious enough to move back to my home country and take care of it there. Or if I will be able to handle this and continue on with my life normally.
Response from Dr. Holodniy
Yes, that amount of protein in the urine, indicates some degree of damage to the kidneys, and the likely cause is high blood pressure. Although it's possible that HIV could have a small contribution here, the duration of infection makes it more unlikely. You don't report any of your liver tests, so it is unclear whether there are any problems with your liver. Given where your CD4 count and viral load are now, there is no urgency to start HIV meds at this point. I would get your blood pressure under control first with meds, and then see over the next few months what the trend in CD4 count and viral load are. You may not need HIV meds for awhile. On the other hand if you do, there are lots of options, assuming where you live, you have access to a variety of HIV meds.
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