Monitoring kidneys and vitamin D

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Post by Jenny McDonald08 Mar 2012

Jenny McDonald has been providing people with HIV with advice about diet and treatments since the 1980s.

She is now doing regular clinics with positive people at the AIDS Action Council of the ACT in Canberra and the Northern Territory AIDS Hepatitis and Related Diseases Council in Darwin, as well as at the Melbourne Sexual Health Centre.

‘The current treatments have made a huge difference to people’s lives,’ said Jenny, ‘but I tell people they still need to be careful to monitor potential side-effects from these medications.

‘For instance, I warn people on Tenofovir to drink extra water every day. I recommend at least six to eight glasses a day or about two litres. This is particularly important if your blood results show that you have an estimated Glomerular Filtration Rate (eGFR) less than 90. (This recommended level has recently been lifted from 60.)

It could mean that the drug is not being flushed through your kidneys adequately which could lead to stones or “kidney sludge” which is a build-up of waste products.

An eGFR greater than 90 is fine (in the absence of significant microalbuminuria), when it is less than 90mL/min/1.73m2 then further investigation is required.

‘I am also seeing large numbers of people in my clinics who are Vitamin D deficient.

No one is saying not to protect yourself from damage from the sun, but all people who are Vitamin D deficient should have skin exposure to the sun for about twenty minutes a day. This is best done in the early morning when UV levels are lowest.

‘Vitamin D levels are tested in your blood. It is particularly important to do this after the winter months, say in September each year.

If you are deficient it may be necessary for you to take Vitamin D supplementation.

‘Low levels of Vitamin D can contribute to bone disease (such as osteoporosis) and other conditions, such as diabetes.’