Renal Disease in HIV: Practical Aspects for Nephrologists

Patients with HIV represents a unique and often seemingly daunting challenge for nephrologists, as these patients often have many multi-system issues, and are on a mix of medications that are not well known or often prescribed by non-infectious disease specialists. HIV is a risk factor for acute kidney injury (AKI)/ chronic kidney disease (CKD), and there is a wide spectrum of renal disease that occurs in these patients, including those directly caused by the virus, and medication toxicities. Once the renal disease is advanced, these patients can also provoke difficult decisions regarding the issues of kidney biopsy, dialysis, and transplant. The nephrologist requires a working knowledge of the current state of overall HIV management, so that they can help with the prevention and treatment of acute and chronic kidney disease, within the multi-disciplinary HIV team.