TY - JOUR
T1 - Screening for Chronic Kidney Disease in HIV-Infected Patients
AU - Estrella, Michelle M.
AU - Fine, Derek M.
N1 - Funding Information:
Dr. Estrella is supported by the NIH/NIDDK grant 1K23DK081317-01A1 . Dr. Fine has received consulting fees and speaker honoraria from GlaxoSmithKline Article
PY - 2010/1
Y1 - 2010/1
N2 - With improved survival afforded by highly active antiretroviral therapy (HAART), CKD has emerged as one of the primary comorbid conditions affecting HIV-infected individuals. Although CKD in HIV-infected individuals is classically thought of as a consequence of advanced HIV infection such as in the case of HIV-associated nephropathy, several factors likely contribute to the development CKD in HIV infection. These factors include genetic predisposition, age-related decline in kidney function, HAART-related metabolic changes, exposure to multiple nephrotoxic medications, and concurrent conditions such as hepatitis C or illicit drug use. Similar to the general population, proteinuria and impaired kidney function are associated with faster progression to acquired immune deficiency syndrome and death. Given the prevalence and impact of kidney disease on the course of HIV infection and its management, current guidelines recommend screening all HIV-infected individuals for kidney disease. This review focuses on the current guidelines for kidney disease screening and discusses traditional as well as promising strategies for detecting CKD in this vulnerable population.
AB - With improved survival afforded by highly active antiretroviral therapy (HAART), CKD has emerged as one of the primary comorbid conditions affecting HIV-infected individuals. Although CKD in HIV-infected individuals is classically thought of as a consequence of advanced HIV infection such as in the case of HIV-associated nephropathy, several factors likely contribute to the development CKD in HIV infection. These factors include genetic predisposition, age-related decline in kidney function, HAART-related metabolic changes, exposure to multiple nephrotoxic medications, and concurrent conditions such as hepatitis C or illicit drug use. Similar to the general population, proteinuria and impaired kidney function are associated with faster progression to acquired immune deficiency syndrome and death. Given the prevalence and impact of kidney disease on the course of HIV infection and its management, current guidelines recommend screening all HIV-infected individuals for kidney disease. This review focuses on the current guidelines for kidney disease screening and discusses traditional as well as promising strategies for detecting CKD in this vulnerable population.
KW - Cystatin C
KW - Estimated glomerular filtration rate
KW - HIV infection
KW - Modification of Diet in Renal Disease equation
KW - Proteinuria
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U2 - 10.1053/j.ackd.2009.07.014
DO - 10.1053/j.ackd.2009.07.014
M3 - Review article
C2 - 20005486
AN - SCOPUS:71249153446
SN - 1548-5595
VL - 17
SP - 26
EP - 35
JO - Advances in Chronic Kidney Disease
JF - Advances in Chronic Kidney Disease
IS - 1
ER -