HIV associated nephropathy prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{HIV associated nephropathy}} | {{HIV associated nephropathy}} | ||
== Overview == | == Overview == | ||
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== 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)]] since it will improve the outcomes. | * [[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) | ||
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** Administration and monitoring of cART and/or [[ACE inhibitor|ACE inhibitors]]/[[Angiotensin II receptor antagonist|ARBs]] | ** Administration and monitoring of cART and/or [[ACE inhibitor|ACE inhibitors]]/[[Angiotensin II receptor antagonist|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|end stage renal disease (ESRD)]]: | * 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 inhibitors or ARBs) | ||
** [[Diabetes]] control | ** [[Diabetes]] control | ||
Revision as of 06:23, 26 June 2020
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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) 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:
- 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.
References
- ↑ 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.
- ↑ 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.