HIV associated nephropathy prevention: Difference between revisions
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== Overview == | == Overview == | ||
[[Human Immunodeficiency Virus (HIV)|HIV]]-positive patients should be screened for [[Chronic kidney disease|chronic kidney disease (CKD)]]. Interventions in HIV-positive patients with renal disease should be done in order to slow the progress and prevent [[End stage renal disease|end stage renal disease (ESRD)]] and they should be referred to a [[nephrologist]]. | [[Human Immunodeficiency Virus (HIV)|HIV]]-positive patients should be screened for [[Chronic kidney disease|chronic kidney disease (CKD)]].<ref name="pmid29872351" /> Interventions in HIV-positive patients with renal disease should be done in order to slow the progress and prevent [[End stage renal disease|end stage renal disease (ESRD)]] and they should be referred to a [[nephrologist]].<ref name="pmid18295067" /> | ||
== HIV Associated Nephropathy Prevention == | == HIV Associated Nephropathy Prevention == | ||
* [[Human Immunodeficiency Virus (HIV)|HIV]]-positive patients should be screened for [[Chronic kidney disease|chronic kidney disease (CKD)]] with the following measurements since it will improve the outcomes.<ref name="pmid29872351">{{cite journal| author=Palau L, Menez S, Rodriguez-Sanchez J, Novick T, Delsante M, McMahon BA | display-authors=etal| title=HIV-associated nephropathy: links, risks and management. | journal=HIV AIDS (Auckl) | year= 2018 | volume= 10 | issue= | pages= 73-81 | pmid=29872351 | doi=10.2147/HIV.S141978 | pmc=5975615 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29872351 }} </ref> | * [[Human Immunodeficiency Virus (HIV)|HIV]]-positive patients should be screened for [[Chronic kidney disease|chronic kidney disease (CKD)]] with the following measurements since it will improve the outcomes.<ref name="pmid29872351">{{cite journal| author=Palau L, Menez S, Rodriguez-Sanchez J, Novick T, Delsante M, McMahon BA | display-authors=etal| title=HIV-associated nephropathy: links, risks and management. | journal=HIV AIDS (Auckl) | year= 2018 | volume= 10 | issue= | pages= 73-81 | pmid=29872351 | doi=10.2147/HIV.S141978 | pmc=5975615 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29872351 }} </ref> | ||
** [[Blood pressure]] measurment | **[[Blood pressure]] measurment | ||
** Checking of [[Creatinine|Cr]] and [[Glomerular filtration rate|GFR]] (kidney function) | ** Checking of [[Creatinine|Cr]] and [[Glomerular filtration rate|GFR]] (kidney function) | ||
** Checking of [[proteinuria]] on urine examination | ** Checking of [[proteinuria]] on urine examination | ||
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* In patients with HIV associated nephropathy the following interventions should be done in order to slow the progress of kidney disease and prevent [[End stage renal disease|end stage renal disease (ESRD)]]:<ref name="pmid18295067">{{cite journal| author=Fine DM, Perazella MA, Lucas GM, Atta MG| title=Kidney biopsy in HIV: beyond HIV-associated nephropathy. | journal=Am J Kidney Dis | year= 2008 | volume= 51 | issue= 3 | pages= 504-14 | pmid=18295067 | doi=10.1053/j.ajkd.2007.12.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18295067 }} </ref> | * In patients with HIV associated nephropathy the following interventions should be done in order to slow the progress of kidney disease and prevent [[End stage renal disease|end stage renal disease (ESRD)]]:<ref name="pmid18295067">{{cite journal| author=Fine DM, Perazella MA, Lucas GM, Atta MG| title=Kidney biopsy in HIV: beyond HIV-associated nephropathy. | journal=Am J Kidney Dis | year= 2008 | volume= 51 | issue= 3 | pages= 504-14 | pmid=18295067 | doi=10.1053/j.ajkd.2007.12.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18295067 }} </ref> | ||
** Blood pressure control (ACE inhibitors or ARBs) | ** Blood pressure control ([[ACE inhibitor|ACE inhibitors]] or [[Angiotensin II receptor antagonist|ARBs]]) | ||
** [[Diabetes]] control | **[[Diabetes]] control | ||
** Avoidance of [[nephrotoxic drugs]] | ** Avoidance of [[nephrotoxic drugs]] | ||
** Smoking cessation | ** Smoking cessation | ||
** Dyslipidemia treatment | ** Dyslipidemia treatment | ||
* HIV-positive patients with renal disease should be referred to a [[nephrologist]] for the following reasons: | * HIV-positive patients with renal disease should be referred to a [[nephrologist]] for the following reasons:<ref name="pmid18295067" /> | ||
** Early management of CKD | ** Early management of CKD | ||
** Disease progression monitoring | ** Disease progression monitoring | ||
** Monitoring of complications | ** Monitoring of complications | ||
** Preparation for [[dialysis]] | ** Preparation for [[dialysis]] | ||
** Preparation for [[kidney transplantation]] | ** Preparation for [[kidney transplantation]] | ||
==References== | ==References== |
Latest revision as of 19:28, 30 June 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
HIV-positive patients should be screened for chronic kidney disease (CKD).[1] Interventions in HIV-positive patients with renal disease should be done in order to slow the progress and prevent end stage renal disease (ESRD) and they should be referred to a nephrologist.[2]
HIV Associated Nephropathy Prevention
- HIV-positive patients should be screened for chronic kidney disease (CKD) with the following measurements since it will improve the outcomes.[1]
- Blood pressure measurment
- Checking of Cr and GFR (kidney function)
- Checking of proteinuria on urine examination
- Administration and monitoring of cART and/or ACE inhibitors/ARBs
- In patients with HIV associated nephropathy the following interventions should be done in order to slow the progress of kidney disease and prevent end stage renal disease (ESRD):[2]
- Blood pressure control (ACE inhibitors or ARBs)
- Diabetes control
- Avoidance of nephrotoxic drugs
- Smoking cessation
- Dyslipidemia treatment
- HIV-positive patients with renal disease should be referred to a nephrologist for the following reasons:[2]
- Early management of CKD
- Disease progression monitoring
- Monitoring of complications
- Preparation for dialysis
- Preparation for kidney transplantation
References
- ↑ 1.0 1.1 Palau L, Menez S, Rodriguez-Sanchez J, Novick T, Delsante M, McMahon BA; et al. (2018). "HIV-associated nephropathy: links, risks and management". HIV AIDS (Auckl). 10: 73–81. doi:10.2147/HIV.S141978. PMC 5975615. PMID 29872351.
- ↑ 2.0 2.1 2.2 Fine DM, Perazella MA, Lucas GM, Atta MG (2008). "Kidney biopsy in HIV: beyond HIV-associated nephropathy". Am J Kidney Dis. 51 (3): 504–14. doi:10.1053/j.ajkd.2007.12.005. PMID 18295067.