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
...agnosis...
...itoring
...mmends monitoring creatinine-based estimated glo...
...sts monitoring kidney damage with urinalysis or a...
...valuati...
...mends that the evaluation of new-onset o...
...recommends that HIV-infected patients with kid...
...IDSA recommends establishing permanent...
...n possible, IDSA recommends avoiding t...
...re 1. Chronic Kidney Disease Classif...
...able 1. Classification of Albuminuria and Prote...
...le 2. Risk Factors for CKD and ESRD: Dat...
...e 3. Laboratory Indicators of Proximal...
Treatment
...reatment
...anagemen...
...nds that clinicians prescribe ART and encourage...
...SA recommends that clinicians use either the CK...
...that patients with biopsy-confirmed or clin...
...nts infected with HIV who have a GFR...
...ir-treated patients who experience a confirmed GF...
Cardiovascular D...
IDSA recommends using angiotensin-con...
...that HIV-infected individuals with pre-ESRD CKD...
...s that clinicians consider prescribing...
Blood Pressure
...mends a target blood pressure o...
...a target blood pressure of 30-300 mg/day...
Corticostero...
...suggests that clinicians consider corticoste...
...dney Transplantatio...
...recommends that HIV providers assess patie...
...ds that HIV providers assess patient...
Children and Adolescents with HIV
...ren and Adolescents with HIV
...eening...
...adults, IDSA recommends that children and ad...
...ests avoiding tenofovir as part of...
...eatment...
...mmends that children and adolescents with...
...ts using ACE inhibitors or ARBs to treat prot...
IDSA suggests that corticosteroids NOT be...
...le 4. Dosing of Antiretroviral Drugs for HIV-...