[Management of renal toxicity in HIV-positive patients. What to measure, how to measure it and how frequently].
Chronic kidney disease in patients with HIV is being recognized as one of the most frequent comorbidities of this disease and consequently much research is currently being performed in this area. The possible manifestations are highly varied and consequently a high index of suspicion is required. Appropriate investigations should be performed from the moment patients first seek care to rule out renal disease and to prevent worsening, with the diagnostic or therapeutic measures that may subsequently be required. One of the most common problems is nephrotoxicity caused by some drugs and cases associated with tenofovir are becoming more frequently described. However, there is wide clinical experience with this drug and renal toxicity associated with its use is uncommon both in clinical trials and in clinical practice. Familiarity with what may happen, the associated factors and appropriate patient management are essential.
Barril Cuadrado
Guillermina
G
Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, España. gbarril43@gmail.com
de Los Santos Gil
Ignacio
I
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000465:Algorithms; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced / Q000175:diagnosis; D015994:Incidence; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D007677:Kidney Function Tests; D007684:Kidney Tubules / Q000503:physiopathology; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D011507:Proteinuria / Q000139:chemically induced / Q000209:etiology; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000068698:Tenofovir; D013997:Time Factors; D001613:beta 2-Microglobulin / Q000652:urine
D019380:Anti-HIV Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D001613:beta 2-Microglobulin; D000068698:Tenofovir; D003404:Creatinine; D000225:Adenine