Question
How does dolutegravir affect my kidney function?
27 January 2025. Related: Changing treatment, Complications and coinfections, Other tests.
My kidney function is slightly reduced lately with my eGFR coming down to 75 and my doctor suggested to switch to Dovato (Dolutegravir – Lamivudine). Is this a good option for me?
Answer
Hello and many thanks for getting in touch.
Kidney function can be reduced throughout our life and in most cases this is not permanent.
Age, medication, dehydration (not having enough fluid intake) can affect the kidney function.
What the eGFR shows:
eGFR shows how fast can your kidneys remove toxins or other waste from your blood.
It is calculated based on your race/ethnicity, weight and height, sex, age and creatinine level.
An eGFR over 60 mL/min/1.73m2 is considered quite good although in the UK the only result within normal range is over 90 mL/min/1.73m2.
To answer your question about Dovato, your doctor is giving you good advice, in my opinion.
Dovato is the best kidney-sparing combination we have available right now.
Sometimes people who take certain medication present lower kidney function on the blood tests but that effect is not present when they are taken off the medication. A very good example for that are the creatine supplements that people take for the gym: the tests present reduced kidney function but if you stop them a week before getting tested the results are back to normal range.
Similarly, dolutegravir increases the creatinine in your blood so it makes your eGFR show a reduced value.
This is to be expected and doesn’t affect your kidneys long-term.
The drugs in Dovato (dolutegravir + lamivudine) have not had any kidney – toxic effect in any studies.
Please let us know how you are getting on.
Hello Ferdz and thanks for getting in touch.
Dolutegravir increases the serum creatinine without causing any problems to the kidneys though but that is the reason your tests look like that.
As for the insomnia, try to take dolutegravir in the morning as this might help your sleep.
In general insomnia is a known side effect of dolutegravir but most people overcome it after a few months.
If that doesn’t happen, you need to raise it with your doctor.
I don’t think peeing at night is related to dolutegravir.
In all honesty it’s the first time I hear about it.
It might be related to the weather, or your intake of fluids.
Try to drink less at night but still consume enough throughout the day as this is the only way to protect your kidneys.
All these are worth discussing with your doctor.
It might be an involvement of your ARVs, especially if you are on TLD that your doctor needs to investigate more.
Why after taking dolutegravir for ten days my creatinine level increased and I often urinate in the evening and i always awake I fell like insomnia and I have these lower back pains and restless legs.