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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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High creatinine levels
Jul 8, 2007

I am a 55 yr old man living with HIV for 20 years. I developed diabetes a few years ago and never had any problems with my A1C. For the last 6 mos my A1C has been high and my creatinine is at 2. I complained I was urinating at least 3 times a night and I had a urine test done. This showed protein in my urine greater than 300 and glucose greater than 1000. I have been on Viramune and Truvada for a few years. Does Viramune and Truvada contribute to high creatinine? I remember several times the doctor calling and telling me to stop all meds. I don't know what to do. I have just done a 24hr urine test and bloodwork and going for a renal ultrasound. It's driving me crazy, will I have to go on Dialysis? Should I stop taking the HIV meds? My HIV physician does not seem to be concerned or care.

Response from Dr. Henry

HIV can cause renal dysfunction (HIV nephropathy) which seems to be a particularly serious problem in Arican-American. Treating HIV effetively is important to slow down that process (so stopping HIV meds is generally not the answer). For decreasing kidney function often changes in the doses of the individual drugs in Truvada needs to be done (need to dose the tenofovir and FTC separately) and tenofovor can aggravate kidney dysfunction so often an alternative drug (like abacavir in HLA B5701 negative patients) is used. Tight/good control of diabetes is also important since diabetes causes renal problems as well. Often drugs like lisonopril (an "ACE" inhibitor) are used to try and protect the kidneys. KH

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