Patient's Query
Hello doctor,
I am a 31-year-old male and was recently prescribed a PEP (post-exposure prophylaxis) course (Truvada and Tivicay) due to a possible very low-risk exposure. I have been taking the medication for 11 days, and today marks the 12th day. However, I have noticed that I experience urine retention shortly after taking the medication, but it subsides after some time. Additionally, I have been experiencing mild back pain almost every day, it comes and goes. After five days on this medication, I underwent a comprehensive metabolic panel (CMP), which showed that my creatinine level had increased from 1.06 to 1.21, and my eGFR (estimated glomerular filtration rate) had decreased from 96 to 82. However, all other parameters remained unchanged.
I am worried about my kidney health and whether these changes will reverse or if the medication is causing ongoing damage. Additionally, my blood pressure is slightly elevated at 137/82. I am unsure whether this is due to stress from the situation or if my kidneys are being affected. I would appreciate any guidance on whether I should be concerned and what steps I should take next.
Kindly suggest.
Hello,
Welcome to icliniq.com.
I understand your concern.
First of all, Truvada (emtricitabine/tenofovir disoproxil fumarate) is known to cause urinary problems such as painful urination and difficulty passing urine. Your symptoms may be due to this side effect. While kidney dysfunction can also occur as a result, it is less likely to develop within just 11 days of starting the medication.
I would advise you to undergo a routine urine test along with a serum cystatin C level test to confirm any kidney dysfunction. Stay well-hydrated by drinking plenty of water every day. Additionally, avoid alcohol, smoking, non-vegetarian foods, and painkillers, as they may further stress your kidneys. Have you undergone any ultrasound (USG) of your kidneys in the past?
I hope this helps you.
Patient's Query
Hello doctor,
I had not undergone a kidney ultrasound before. I will get the cystatin test done. I have a few questions regarding my situation.
Is the kidney damage caused by PEP reversible? If so, how long does it typically take to recover after stopping the medication? I am currently on day 12 of a 28-day PEP course. Can continuing it for the full duration cause kidney dysfunction? If dysfunction does occur, is it reversible after stopping the medication? Additionally, I confirmed with the source yesterday that she tested negative on a rapid test. Should I stop taking PEP? My only concern is that I do not know her well, and if she was infected within the last two to four weeks, it may not yet show on a rapid test.
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
It is not confirmed whether your rise in creatinine is due to PEP (post-exposure prophylaxis) or just a normal variation in your lab report, as the increase is not very significant. To determine whether there is any actual kidney injury, it would be advisable to get a Cystatin C test for further confirmation.
You should continue taking your medication. However, if you believe you had exposure to a high-risk partner, it is best not to take any chances with your health.
I hope this helps you.
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Answered byDr. Yash Kathuria
Medically reviewed byiCliniq medical review team
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