Renal complications in HIV disease: between present and future.
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.
Clinic of Infectious Disease, University Hospital, Bari, Italy. p_maggi@yahoo.com
Paolo
P
Maggi
Dario
D
Bartolozzi
Paolo
P
Bonfanti
Leonardo
L
Calza
Chiara
C
Cherubini
Antonio
A
Di Biagio
Simone
S
Marcotullio
Francesco
F
Montella
Vincenzo
V
Montinaro
Cristina
C
Mussini
Pasquale
P
Narciso
Stefano
S
Rusconi
Fabio
F
Vescini
D016263:AIDS-Associated Nephropathy / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D019380:Anti-HIV Agents / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors
D019380:Anti-HIV Agents