HIV associated nephropathy prevention

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Overview

HIV-positive patients should be screened for 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 (ESRD) and they should be referred to a nephrologist.

HIV Associated Nephropathy Prevention

• HIV-positive patients should be screened for chronic kidney disease (CKD) since it will improve the outcomes. Screening measurements for renal disorders are:
  • 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):
  • 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:
  • Early management of CKD
  • Disease progression monitoring
  • Monitoring of complications
  • Preparation for dialysis
  • Preparation for kidney transplantation  

• Kidney biopsy is an essential tool for evaluation and identification of HIV-associated and other kidney diseases in HIV-positive patients, which is important in the management and treatment of the patients.