Human immunodeficiency virus infection in end-stage renal disease patients.
Human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) offers many diagnostic and therapeutic challenges to nephrologists. Renal failure may be a direct consequence of viral infection (HIV-associated nephropathy), or intrinsic renal diseases may occur in previously infected individuals. Patients receiving renal replacement therapy (RRT) may acquire HIV infection from blood transfusions, renal allografts, sexual contacts, or needle sharing by drug addicts. In the early 1980s, the overall prognosis of patients with the acquired immunodeficiency syndrome (AIDS) was very poor, and survival of those with ESRD was dismal. Consequently many even questioned the value of providing maintenance dialysis to patients with AIDS. With advances in diagnostic techniques in serologic and viral markers of disease, and deployment of highly effective antiretroviral agents, the prognosis of HIV-infected patients has dramatically improved. Over the past two decades, experiences in the management of HIV patients with ESRD is accumulating. Both peritoneal dialysis and hemodialysis are effective modes of therapy and many centers are now beginning to perform renal transplantation in HIV-infected patients. This article deals with various aspects of HIV infection in patients with ESRD.
Rao
T K Sreepada
TK
Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, USA. tksrao@pol.net
D016263:AIDS-Associated Nephropathy / Q000150:complications; D000488:Allied Health Personnel; D019380:Anti-HIV Agents; D023241:Antiretroviral Therapy, Highly Active; D015897:Comorbidity; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D010530:Peritoneal Dialysis; D011379:Prognosis; D006435:Renal Dialysis
D019380:Anti-HIV Agents