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23 May 2019
Case presentation
A 48-year-old male presented with nausea, vomiting, diarrhea and dizziness.
History
The patient suffered from human immunodeficiency virus for which he was taking antiretroviral agents. Moreover, he had a solitary kidney. He underwent radiation, chemotherapy, and ultimately, a unilateral nephrectomy for Wilms tumor approximately 22 years ago.
Investigations
Diagnosis
Gastrointestinal side effects with antiretroviral agents used for treating human immunodeficiency virus.
Management
The patient was switched to efavirenz 600 mg /emtricitabine 200 mg /tenofovir disoproxil fumarate 300 mg once daily. Various parameters few months after the treatment were serum creatinine: 1.41 mg/dL, estimated creatinine clearance: 65.2 mL/min (body weight: 73.2 kg), estimated glomerular filtration rate: 68.2 mL/min/1.73 m2, with a CD4 cell count of 120 cells/mm3. The HIV viral load was undetectable. No evidence of nephrotoxicity was reported over a course of 19 months. Moreover, renal function was adequately maintained. Treatment with tenofovir disoproxil fumurate-based regimen appeared to be a viable option for this patient with a solitary kidney and human immunodeficiency virus.
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