Executive summary of the consensus document on the management of renal disease in HIV-infected patients

Nefrologia. 2014 Nov 17;34(6):768-88. doi: 10.3265/Nefrologia.pre2014.Sep.12745.
[Article in English, Spanish]

Abstract

The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in HIV-infected patients. Renal function should be monitored in all HIV-infected patients. The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glucosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document provides indications for renal biopsy and advises on the optimal time for referral of a patient to the nephrologist. The indications for and evaluation and management of dialysis and renal transplantation are also addressed.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Anemia / etiology
  • Anemia / therapy
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / pharmacokinetics
  • Anti-HIV Agents / therapeutic use
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / therapy
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Complications / therapy
  • Disease Management
  • Disease Progression
  • Drug Interactions
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Hepatitis, Viral, Human / epidemiology
  • Humans
  • Hyperlipidemias / drug therapy
  • Hyperlipidemias / epidemiology
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacokinetics
  • Immunosuppressive Agents / therapeutic use
  • Kidney Function Tests
  • Kidney Transplantation
  • Nephrology
  • Overweight / epidemiology
  • Pancreas Transplantation
  • Referral and Consultation
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / therapy*
  • Renal Replacement Therapy
  • Urinalysis

Substances

  • Anti-HIV Agents
  • Immunosuppressive Agents