Renal complications in HIV disease: between present and future

AIDS Rev. 2012 Jan-Mar;14(1):37-53.

Abstract

The recent introduction of new antiretroviral drugs, characterized by high efficiency and improved safety profiles, has not reduced the incidence of long-term adverse effects, in some cases manifested as selective organ damage. The presence of organ damage in patients receiving antiretroviral treatment is not only the expression of treatment toxicity, but also a complex interaction between individual risk factors, HIV-correlated effects, and antiretroviral drug toxicity. Kidney damage belongs to these adverse events. Renal function abnormalities are present in a large percentage of patients with HIV infection. Moreover, HIV-associated renal disease seems to be associated with progression to AIDS and death. In this review we address the various aspects of the epidemiology of renal damage, the interaction and the convergent effect of HIV and antiretroviral drugs in the onset of kidney injury, the interplay between kidney function and other organ systems, early clinical management, the monitoring of renal function, and a proposal of clinical approach to kidney disease in daily practice. Finally, we discuss future perspectives of renal damage in HIV patients and evaluate the patient's perspective.

Publication types

  • Review

MeSH terms

  • AIDS-Associated Nephropathy / chemically induced
  • AIDS-Associated Nephropathy / epidemiology
  • AIDS-Associated Nephropathy / etiology*
  • AIDS-Associated Nephropathy / virology
  • Anti-HIV Agents / adverse effects*
  • Early Diagnosis
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / epidemiology
  • Kidney Diseases / etiology*
  • Kidney Diseases / virology
  • Male
  • Prevalence
  • Prognosis
  • Risk Factors

Substances

  • Anti-HIV Agents