Executive summary of the recommendations on the evaluation and management of renal disease in human immunodeficiency virus-infected patients

José L. Gorriz, Félix Gutiérrez, Joan C. Trullàs, Piedad Arazo, Jose R. Arribas, Guillermina Barril, Miguel Cervero, Frederic Cofán, Pere Domingo, Vicente Estrada, Xavier Fulladosa, María J. Galindo, Sílvia Gràcia, José A. Iribarren, Hernando Knobel, José López-Aldeguer, Fernando Lozano, Alberto Martínez-Castelao, Esteban Martínez, Maria A. MazuecosCelia Miralles, Rosario Montañés, Eugenia Negredo, Rosario Palacios, María J. Pérez-Elías, Joaquín Portilla, Manuel Praga, Carlos Quereda, Antonio Rivero, Juan M. Santamaría, José Sanz, Jesús Sanz, José M. Miró

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Abstract

© 2014 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved. The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in human immunodeficiency virus (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 glycosuria. 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.
Original languageEnglish
Pages (from-to)583-597
Number of pages15
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume32
Issue number9
DOIs
Publication statusPublished - 1 Nov 2014

Keywords

  • AIDS
  • Antiretroviral therapy
  • Chronic kidney disease
  • Human immunodeficiency virus
  • Renal failure
  • Renal toxicity
  • Renal transplantationa
  • Tenofovir

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