Kidney issues

Question

I went for my routine blood work in October 2014 and found that my GFR was at 70. My doc ordered an ultrasound to see if there were any other issues..all came back ok. In Nov GFR was at 60 and late dec down to 46. We switched my meds from atripla to kivexa and sustiva in Dec. My latest GFR taken in Feb climbed up to 50. My doc says that it can take months even a year to see Gfr bounce back to over 60 which he says is a more manageable number. He was optomistic that there was no more protein or sugar in the urine(there was before) but the creatine levels remained higher than normal...with a very modest decrease from previous tests. Is this slow climb typical when stopping the atripla? Is there anything else I should be doing. I have not been referred to a specialist yet.

Answer

You don't indicate what your kidney tests were before starting Atripla. Although these kidney function results could be the result of Atripla (particularly the tenofovir component) you need to make sure there are no other kidney related problems, perhaps from other medical conditions like hypertension, diabetes, etc, that are contributing. We do know improvement in GFR can be seen after stopping meds and is very variable in how long it takes. Again, other factors (like other meds that affect the kidney, age, other medical conditions) affect how much and how fast improvement might be seen.