Jun 3, 2009
ON TREATMENT FOR FIVE YEARS: LAST LABS AS OF JAN 09 CD4 450 18%, VL NON-DETECT., ON: BOOSTED REYETAZ, TRUVADA. WAS HAVING BURNING ON URINATION AND RIGHT FLANK DISCOMFORT. DID UA = GLUCOSE 500 PROTEIN 30 SMALL BLOOD. I AM NOT DIABETIC, FINGER STICK AT TIME OF UA WAS 89 GLUCOSE. DID BASIC METABOLIC = ALL NORMAL INCLUDING KIDNEY FUNCT.... OTHER DRUGS = BACTRIM DS, CELEBREX, WELLBUTRIN, MICARDIS, CLONOPIN, MARINOL, MULTI-VIT., PRAVASTATIN, NO HISTORY OF KIDNEY DYSFUNCTION OR HYPERGLYCEMIA.... CAN THINK OF NO OTHER REASON OTHER THAN DRUG INVOLVEMENT FOR THE UA FINDINGS? POSSIBLY THE TRUVADA, BACTRIM, CELEBREX? DOC WANTS A 24HR URINE CREAT. CLEARANCE DONE.... I HAD SOME COMBIVIR LEFT FROM A PREVIOUS REGIMINE THAT I AM REPLACING THE TRUVADA WITH FOR NOW.... ANY THOUGHTS....?
Response from Dr. Henry
You may need to be evaluated for a kidney stone (atazanvir can cause kidney stones), a urinary tract infection (with culture), and overall kidney function (including protein and determining 24 hour creatinine clearance). The switch to Combivir may not be needed depending on the ultimate diagnosis-would discuss with your HIV doctor. KH
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