Serum creatinine elevation after switch to dolutegravir in a human immunodeficiency virus-positive kidney transplant recipient

Transpl Infect Dis. 2016 Aug;18(4):625-7. doi: 10.1111/tid.12545. Epub 2016 Jun 20.

Abstract

Dolutegravir is a preferred antiretroviral drug for human immunodeficiency virus (HIV)-infected patients following solid organ transplantation. It has potent antiretroviral activity and does not interact with calcineurin inhibitors. We describe a case of an HIV-infected kidney transplant patient, who was noted to have a rising serum creatinine following initiation of dolutegravir. At first, an acute rejection episode was suspected, but this finding was later attributed to inhibition of creatinine secretion by dolutegravir. We suggest that an awareness of this potential effect of dolutegravir is important for providers who take care of HIV-positive kidney transplant recipients, in order to prevent potentially unnecessary testing.

Keywords: antiretroviral; creatinine; dolutegravir; human immunodeficiency virus; kidney transplant.

Publication types

  • Case Reports

MeSH terms

  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / adverse effects*
  • Anti-Retroviral Agents / therapeutic use
  • Calcineurin Inhibitors / therapeutic use
  • Creatinine / blood*
  • Drug Interactions
  • Drug Substitution*
  • Drug Therapy, Combination
  • Graft Rejection / blood*
  • Graft Rejection / prevention & control
  • HIV / immunology
  • HIV Seropositivity / blood
  • HIV Seropositivity / drug therapy*
  • Heterocyclic Compounds, 3-Ring / administration & dosage
  • Heterocyclic Compounds, 3-Ring / adverse effects*
  • Heterocyclic Compounds, 3-Ring / therapeutic use
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Oxazines
  • Piperazines
  • Pyridones

Substances

  • Anti-Retroviral Agents
  • Calcineurin Inhibitors
  • Heterocyclic Compounds, 3-Ring
  • Immunosuppressive Agents
  • Oxazines
  • Piperazines
  • Pyridones
  • Creatinine
  • dolutegravir