Chronic Kidney Disease in HIV-Infected Patients
Key Points
Key Points
- The risk of chronic kidney disease (CKD) is increased in individuals infected with human immunodeficiency virus (HIV) compared with the general population.
- In African Americans, HIV infection imparts a risk for end-stage renal disease (ESRD) that is of similar magnitude to that of diabetes.
- -infected patients, including direct effects by HIVA constellation of potential factors contributes to excess kidney disease in HIV-infected patients, including direct effects by HIV infection, HIV-associated immune activation, drug toxicity, coinfection with hepatitis C virus, and a high prevalence of traditional kidney disease risk factors.
Diagnosis
...Monito...
...ommends monitoring creatinine-based estimate...
...monitoring kidney damage with urinalysis or a...
...Ev...
...ends that the evaluation of new-onset or newly di...
...recommends that HIV-infected patients...
...possible, IDSA recommends establishing per...
...ible, IDSA recommends avoiding the use of p...
...hronic Kidney Disease Classification Ac...
...ble 1. Classification of Albuminuria and...
...2. Risk Factors for CKD and ESRD: Data From St...
...e 3. Laboratory Indicators of Proximal Tubul...
Treatment
...Treat...
...Management...
...that clinicians prescribe ART and en...
...ommends that clinicians use either the CKD Epid...
...SA recommends that patients with biopsy-confirm...
...ents infected with HIV who have a GFR...
...ofovir-treated patients who experience a confirmed...
...Cardiovascular...
...ommends using angiotensin-converting enzyme (ACE...
...recommends that HIV-infected individ...
...hat clinicians consider prescribing aspirin (7...
...Blood Pressure...
...DSA recommends a target blood p...
...s a target blood pressure of 30-300 mg/day...
...Cor...
...that clinicians consider corticosteroids as an...
...Kidney Transplan...
...mmends that HIV providers assess patients...
...ends that HIV providers assess patients with H...
Children and Adolescents with HIV
Childre...
...Sc...
...ults, IDSA recommends that children and adolescen...
...ts avoiding tenofovir as part of first-line the...
...Treatment...
...nds that children and adolescents with HIV who ha...
...ing ACE inhibitors or ARBs to treat protein...
...that corticosteroids NOT be used i...
Table 4. Dosing of Antiretroviral Drugs for HIV...