title: Serum creatinine elevation after switch to dolutegravir in a human immunodeficiency virus-positive kidney transplant recipient.
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.
authors.affiliation: Division of Infectious Diseases and HIV Medicine, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Malat
authors.affiliation: Division of Infectious Diseases and HIV Medicine, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Bias
authors.affiliation: Division of Nephrology, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Harhay
authors.affiliation: Division of Nephrology, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ranganna
authors.affiliation: Division of Nephrology, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Doyle
mesh_terms: D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood*; D004347:Drug Interactions; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000097:blood* / Q000517:prevention & control; D006678:HIV / Q000276:immunology; D006679:HIV Seropositivity / Q000097:blood / Q000188:drug therapy*; D006575:Heterocyclic Compounds, 3-Ring / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099226:Dolutegravir
chemical_list: D044966:Anti-Retroviral Agents; D065095:Calcineurin Inhibitors; D003404:Creatinine; D006575:Heterocyclic Compounds, 3-Ring; D007166:Immunosuppressive Agents; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099226:Dolutegravir
keywords: antiretroviral; creatinine; dolutegravir; human immunodeficiency virus; kidney transplant