Question
I am worried about kidney function and have transmitted drug resistance
6 September 2013. Related: All topics, Living with HIV long-term, Side effects.
I’m worried about my kidney function. I now have had a few tests which have shown poor results and have been switched from an atazanavir combination to darunavir.
What happens if the results don’t improve? I already have transmitted resistance to one class of drugs.
What can be done to combat kidney impairment?
Answer
Hi
Without more details it is difficult to comment on your individual health.
Kidney function can be measured in many ways. One of these for HIV positive people is to use a test called eGFR. This stands for estimated glomerular filtration rate.
See this link for more information, including on how this is graded:
https://i-base.info/guides/side/kidney-toxicity
The normal range is pretty wide though (above 90) and sometimes “poor” refers to a lab result that is just slightly lower, but which is unlikely to be serious. Without knowing your results it is therefore difficult – and not a good idea – to comment on your individual health. The information would be different if your eGFR is 70 or 50 or 30 for example.
In general, kidney function also goes down as we age, and is affected by gender and race. It sounds like your clinic are monitoring you carefully but these are questions you need to speak to your doctor about.
Sometimes after switching from a drugs that is linked to reduced kidney function, eGFR can increase again. I don’t know of other things than can specifically improve kidney function, other than avoiding meds that might make this worse and making sure you routinely drink water during the day to help your kidneys work better.
If your kidney function is more seriously impaired, the other dietary advice is usually important – avoiding certain foods and following a low salt diet etc. This is unlikely to be needed if your reading is only slightly low though.
About 1 in 10 people who are newly diagnosed in the UK are likely to have HIV that includes one or more drug resistance mutations. Having resistance to more than one drug class in much less common, but again, without details of your situation it is difficult to comment.
Luckily, the number of HIV drugs available in the UK means that you are still likely to have many options for making a combination that will still work for you. Ongoing research is also likely to continue to develop better drugs that are also effective against drug resistance.
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