Detection of a steadily declining eCrCl should prompt a consultation with a nephrologist or evaluation of other potential threats to renal health in patients receiving PrEP.
Renal function should be assessed at baseline and at least every 6 months after PrEP initiation. More frequent monitoring or additional tests, such as urinalysis for proteinuria, may be required in patients with other risks to renal health, including hypertension and diabetes.
There is no need to withhold PrEP in patients with a rise in serum creatinine, as long as eCrCl remains ≥ 60 mL/min for those taking tenofovir disoproxil fumarate-emtricitabine. There is currently no CDC guidance for rise in serum creatinine with use of tenofovir alafenamide-emtricitabine for PrEP; however, this medication can be used in patients with lower baseline eCrCl (≥30 mL/min).
Learn more about monitoring patients receiving PrEP.
For additional information, refer to the CDC PrEP guidelines.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Jason F. Okulicz. Fast Five Quiz: HIV Preexposure Prophylaxis-Associated Testing - Medscape - Mar 31, 2020.
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