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Kidney Damage; long term prognosis
Dec 11, 2010

I am 54, and I have been HIV postive since 2003, I have been on meds since the beginning. I have Tcell count of 800, and undetectable. I take Epsicom Reyataz and Norvir. I also take 3 anti-anxiety and anti-depressent drugs. About a year ago, I switched to an HMO from a private doctor and I found out that I have chronic kidney disease. My prior doctor never told me that-he had mentioned that he did not want to destroy my kidneys when he switched me off Truvada a month before I left his treatment. Now my GFR is in the low 50s. I do not have high blood pressure, no diabetes, no family history of kidney issues or diabetes, I work out and am lean. My colesterol ws recently high so I am taking a low dose of Lipitor.

My question is--how long will it be before my CKD progresses to renal failure. I have been in good health with no symptoms. Is it guaranteed that my numbers will get worse, or is it possible the numbers will stay where they are? I searched the web but no answers. Also, should I consider dropping/switching and meds?

Response from Dr. Henry

The prognosis for kidney problems in the setting of HIV Infection varies widely depending on the contributing factors. HIV infection can cause kidney damage so good HIV control is important (may need to adjust the dosing of the Epzicom). Looking for protein in urine and having a renal evaluation to determine as well as possible the etiology of the kidney dysfunction (sometimes kidney biopsy needed) is important so that treatment can be focused on the root cause. The rate of further decline in kidney function is highly variable but as one ages there often is a slow decline so aggressive diagnostic work-up and treatment is advised for persons with already marginal kidney funciton. KH



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