title: Antiretroviral therapy and the kidney.
abstract: Acute kidney injury (AKI) and chronic kidney disease (CKD) are more common in the HIV-infected population than in the general population. AKI is associated with an increased risk of heart failure, cardiovascular disease, end-stage renal disease (ESRD), and mortality. Tenofovir is associated with severe AKI in a small percentage of patients and with subclinical abnormalities in many more. HIV-associated nephropathy is now a relatively rare form of CKD, because of the widespread use of potent antiretroviral therapy. The CKD spectrum in HIV-infected patients has become more frequently characterized by comorbid CKD, with an increased frequency of CKD related to diabetes or hypertension being observed. Kidney transplantation is a therapeutic option for HIV-infected patients with ESRD if their HIV infection is controlled, although rates of acute graft rejection and drug-drug interactions are high. This article summarizes a presentation by Christina M. Wyatt, MD, at the IAS-USA continuing education program held in Washington, DC, in June 2013.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Wyatt
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006651:Histocytochemistry; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology; D008875:Middle Aged
chemical_list: D044966:Anti-Retroviral Agents
references.citation: Clin Infect Dis. 2005 Jun 1;40(11):1559-85
references.pmid: 15889353
references.citation: J Infect Dis. 2013 May 1;207(9):1359-69
references.pmid: 23382571
references.citation: Top Antivir Med. 2012 Aug-Sep;20(3):106-10
references.pmid: 22954611
references.citation: Am J Kidney Dis. 2003 May;41(5):1060-4
references.pmid: 12722041
references.citation: JAMA. 2012 Jul 25;308(4):387-402
references.pmid: 22820792
references.citation: AIDS. 2010 Jul 17;24(11):1667-78
references.pmid: 20523203
references.citation: Am J Kidney Dis. 2009 Dec;54(6):1034-42
references.pmid: 19783343
references.citation: Science. 2010 Aug 13;329(5993):841-5
references.pmid: 20647424
references.citation: AIDS Patient Care STDS. 2012 Jan;26(1):5-11
references.pmid: 22136504
references.citation: Nephrol Dial Transplant. 2011 Oct;26(10):3224-9
references.pmid: 21372250
references.citation: Antivir Ther. 2007;12(2):267-72
references.pmid: 17503669
references.citation: Antimicrob Agents Chemother. 2006 Oct;50(10):3297-304
references.pmid: 17005808
references.citation: N Engl J Med. 2010 Nov 18;363(21):2004-14
references.pmid: 21083386
references.citation: Nat Genet. 2008 Oct;40(10):1175-84
references.pmid: 18794856
references.citation: Clin J Am Soc Nephrol. 2009 Nov;4(11):1766-73
references.pmid: 19808221
references.citation: Kidney Int. 2005 Apr;67(4):1526-31
references.pmid: 15780107
references.citation: Kidney Int. 2010 Sep;78(5):478-85
references.pmid: 20520594
references.citation: AIDS. 2007 Jun 19;21(10):1273-81
references.pmid: 17545703
references.citation: Clin Infect Dis. 2014 Jan;58(1):1-10
references.pmid: 24343580
references.citation: Clin Infect Dis. 2010 Sep 1;51(5):496-505
references.pmid: 20673002
references.citation: AIDS. 2006 Feb 28;20(4):561-5
references.pmid: 16470120
references.citation: J Acquir Immune Defic Syndr. 2012 Sep 1;61(1):32-40
references.pmid: 22732469