Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:
- Age
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Dear Martin,
I have ART treatment from July this year with 3 pills. Tenovavir, Dulutegravir and Lamivir. As of September viral load is undetectable and CD4 count is 917 and CD4 is 41,31%.
SGOT 17, SGPT15 and Alk, phosphate 53 so all within the standard values.
BUN 27, creatinine 1,44 and GFR 45,2.
Yesterday I went to the doctor at the hospital.
question 1: the doctor considered the possibility of going on a 2 pill regimen and dropping Dulutegravir. Strangely enough, he left the choice to me. When I let him know that I didn't know what to choose, he continued the treatment with 3 pills.
Do you have any comments on this?
question 2; my BUN value is slightly higher than before. The doctor thought the creatinine value was more important and that was good. The increased BUN value is due to, among other things, eating red meat, he said. I can't find much on the internet what to do, except drink a lot, to get BUN value back within normal values. Can you advise me about what to eat and what not to eat, for example? How serious is a BUN value of 27 while Creatinine and GFR are more acceptable given my age of 81? Do I have to have BUN value checked regularly, for example after 1 month?
For blood pressure use is Diovan 80mg and 12.5mg HCTZ per day.
Thank you for your advice.
Regards,
J.
******
Dear J,
Trials are underway to see what happens if you omit one of the resources. Maybe the doctor is in on it.
For people who also have Hepatitis B, it is better not to omit anything.
Your decision to just go ahead with all three seems excellent to me.
The BUN value does indeed go down with a lot of drinking. 27 at your age is nothing to worry about and going on a special diet for that seems a bit excessive to me.
Low-protein diet can lower BUN. Lots of vegetables and little meat.
Testing every three months is sufficient.
Yours faithfully,
Dr. Maarten