Damn! 5 weeks on Prep and already problems

[Guest]

I started Prep 5 weeks ago and had a blood test to check on kidney function and already I show a 6 point drop in eGFR and an increase of 5 points in creatinine clearance

my numbers are eGFR was 74 now 68

creatinine was 1.06 now 1.13

comments welcome 

ready to toss my bottle 

[viking8x6]

1 hour ago, Kennethk13 said:

I started Prep 5 weeks ago and had a blood test to check on kidney function ...

From one test you absolutely can't tell whether the function dropped and then stabilized at the lower level, or it is still dropping. I guess (but I don't know for sure) it would be worth waiting for another month and getting a second test to find out. You might want to ask your provider.

[BiAggieGuy]

Some people just don't tolerate certain medications at all.

I can't take Crestor. My doctor prescribed it and within 3 days my arms and legs ached so bad I could barely move. Lipitor does the same but to a lesser degree. A different statin doesn't cause any side effects at all and works great.

Definitely go talk with your doctor, the sooner the better and if you're worried about the medication harming you, stop taking until at least you see the doctor.

[Mattsdarkside]

I had the same problems but only after several months on PrEP, the numbers would return to normal if I stopped for a week or two.  

Thing is, even tho I’m a hungry slutty cockwhore, my fucking tends to be a little streaky, with bursts of activity then breaks that will go a few weeks, so I switched to an on-demand PrEP regimen (I’ve heard it called PrEP 2-1-1 due to dosing patterns).

So far so good: still slutty, still neg, kidneys are staying healthy.

I wasn’t staying 100% compliant because sometimes a hot fuck opportunity will present itself and I’ll go for it.  Knowing this,  I just started keeping some Truvada with me so I can pop the first two (of the 2-1-1 regimen) as needed.  Supposedly it’s “safe” if you take the first two 2-24 hours before a fuck.  

[fuckyouraw777]

If one reacts so bad to PREP, wouldn't that be an indicator that one would find difficulty in getting an appropriate HIV treatment regime?

[Guest]

From what I’m reading truvada was phased out for many patients because of the kidney toxicity and has been replaced with treatments less damaging to the kidneys. The problem is these meds are not used as Prep. 

[tallslenderguy]

Are you taking other meds in addition to PreP? Even over the counter (NSAIDS are cleared by the kidneys). Definitely talk with your healthcare provider, though that isn't a huge bump (it's a .07 bump on the creatinine, not 5... a 5 point bump would take your GFR under 15 and into accute renal failure.  Your GFR was lowish before the PreP, so it seems like you may already have some kidney injury prior to taking PreP.  Be a good idea to have a Doc, or a pharmacist, review your med list... make sure you list everything, including over the counter stuff. Could be a combination, could be dehydration, but does need attention. 

Edited June 10, 2019 by tallslenderguy

[SubHornyBottom]

13 hours ago, vnaught8x6 said:

From one test you absolutely can't tell whether the function dropped and then stabilized at the lower level, or it is still dropping. I guess (but I don't know for sure) it would be worth waiting for another month and getting a second test to find out. You might want to ask your provider.

It's always hard to find a provider plus getting appointment takes forever.

[SubHornyBottom]

3 hours ago, fuckyouraw777 said:

If one reacts so bad to PREP, wouldn't that be an indicator that one would find difficulty in getting an appropriate HIV treatment regime?

Yes, that's true !!!

[tallslenderguy]

13 hours ago, fuckyouraw777 said:

If one reacts so bad to PREP, wouldn't that be an indicator that one would find difficulty in getting an appropriate HIV treatment regime?

Not necessarily.  

There are a lot of HIV meds available now, different formulations effect people differently. Truvada (the med used for PreP) is a Nucleoside/nucleotide reverse transcriptase inhibitor.  There are currently 10 different HIV meds in this class, Truvada is just one of them. i think there are currently eight different classes of HIV meds and in most cases, each class has several available that are similar but different and thus may produce side effects in some, but not others.  Integrase Inhibitors were a big advance, there are currently four different drugs in that class. Then there are meds that combine classes ("Multiclass") that take meds from a couple of classes and combine them into a single dose. HIV treatment always includes drugs from a couple of classes or a multi class med. That's how the virus has been brought under control, it's essentially a one/two punch vs just hitting it at in  just one place. 

Here is an accurate resource on the topic:  https://www.healthline.com/health/hiv-aids/medications-list

Edited June 10, 2019 by tallslenderguy

[tallslenderguy]

10 hours ago, SubHornyBottom said:

It's always hard to find a provider plus getting appointment takes forever.

This is, unfortunately, true.  A possible solution is to go to a doc-ina-box (aka "urgent care"), tell them the meds you are on and ask for a BMP (basic metabolic panel). That's a standard test that includes creatinine and GFR, or you can just ask for those two (may be cheaper that way, idk).  It's a pretty fast process and you'll likely have what you need in a couple of days, i.e., same day doc visit and lab draw, a day or so for the results, often same day.  At the hospital where i work, we get those test results in about an hour. 

[Guest]

My GFR is all over the map so it’s hard to tell if the truvada is having any effect at all and that makes it difficult to decide whether to continue treatment. In January of this year my eGFR was 80 and creatinine was 1.00. In April(before I started Prep) it dropped to 66 and my creatinine was 1.06. Then in May my eGFR on two separate tests were 74 and 73. That’s when I started Prep. After 5 weeks on Prep my eGFR was 68 and creatinine was 1.13

confused 

[tallslenderguy]

1 hour ago, Kennethk13 said:

My GFR is all over the map so it’s hard to tell if the truvada is having any effect at all and that makes it difficult to decide whether to continue treatment. In January of this year my eGFR was 80 and creatinine was 1.00. In April(before I started Prep) it dropped to 66 and my creatinine was 1.06. Then in May my eGFR on two separate tests were 74 and 73. That’s when I started Prep. After 5 weeks on Prep my eGFR was 68 and creatinine was 1.13

confused 

If i were you, i'd consult with a nephrologist. Not suggesting that Truvada is not a contributing factor, but it is not really clear cut since you have a history of kidney issues prior to Truvada. 

In addition to being a critical care nurse, i am also certified (through Cornell University) in reversing certain disease proscesses through diet. I'd estimate (conservatively) that 85% of the patients i care for in hospital have diseases that are directly related to diet (and preventable).  Without knowing you specifically, i can only speak to generalities. The vast majority of people with kidney disease have it because of vascular disease. Pretty much, if you are American or have eaten the Western Diet your whole life, you have vascular disease.  With kidneys, it's usually high blood pressure (HTN) or type two diabetes (DM2) that ends up harming the kidneys, NSAID's are another culprit.  You are still in the early stages.  If you have HTN, you need to get it under control and keep it that way, otherwise it will shred (almost literally) your nephrons (the functional part of your kidney that filters urine), you have about a million per kidney, so you can imagine how tiny and fragile they can be. Most HTN is caused by vascular disease (BTW, that's true about ED as well). The vascular disease is atherosclerosis and eventual atherostenosis resulting from plaque built up from eating animal fat.

i'm way over simplifying this stuff, i cannot provide a science degree in a paragraph, but i am an evidence based professional, i can subtantiate what i proffer with evidence. I.e. i am evidence based vs authority based. I do have the science education and degree, but i don't go on my authority from that degree, but rather rely on peer reviewed study evidence. That's not perfect, but i think science is the best we have, when used properly. The only diet with evidence for reversing vascular disease is a whole food plant based diet (WFPBD) with no added oils, salt or sugar. It's hard, kinda vegan on crack lol, but it can reverse HTN, DM2 and atherosclerosis, the most common causes of kidney disease. 

[Guest]

Dr says I’m fine and not to worry

I have a physical annually. Cholesterol is low, CRP is .02, no inflammation. I eat fish and poultry, no red meat, blood pressure is normal.

No Ed or other health issues

do have a history of kidney stones 

at 6ft, 160lbs, runner for 40 years and average 30 miles a week. Dr says I’m fine and when I mentioned nephrologist he commented that a nephrologist would not see me until my eGFR was below 50 

[h2d2]

After 15 months on PrEP my eGFR was fluctuating between 58 - 63 and I went off it for 3 months.  eGFR recovered to ~73.  I went back on PrEP and it dropped again, hovering around the 60 mark, however I stayed on PrEP but had some scans to check for possible pre-existing renal conditions or damage. All good.  Eventually I had a proper GFR test.  My estimated GFR on that day was 63; actual was 84.  All other health indications are good (excellent blood pressure) so I've been given the ok to stay on PrEP (with 3-monthly kidney bloods).  During this process one of the PrEP specialists remarked that the protocol required a minimum eGFR of 60 prior to going on PrEP; they knew most people's eGFR would take a hit of 5-15 points when starting PrEP.   

My eGFR is also all over the place - I've had a low of 57 and high of 70 when on PrEP, but too few readings before I started to know if that's "normal" for me.  Definitely not being properly hydrated is a factor in some of my low readings, but after all is IS just an estimate and the specialist I saw said it can vary by the hour.