title: Consensus document on the management of renal disease in HIV-infected patients.
abstract: OBJECTIVE
  To update the 2010 recommendations on the evaluation and management of renal disease in HIV-infected patients.
  
  
  METHODS
  This document was approved by a panel of experts from the AIDS Working Group (GESIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Nephrology (S.E.N.), and the Spanish Society of Clinical Chemistry and Molecular Pathology (SEQC). The quality of evidence and the level of recommendation were evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
  
  
  RESULTS
  The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, Urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glucosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document advises on the optimal time for referral of a patient to the nephrologist and provides indications for renal biopsy. The indications for and evaluation and management of dialysis and renal transplantation are also addressed.
  
  
  CONCLUSIONS
  Renal function should be monitored in all HIV-infected patients. The information provided in this document should enable clinicians to optimize the evaluation and management of HIV-infected patients with renal disease.
authors.forename: José L
authors.initials: JL
authors.lastname: Górriz
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: Joan C
authors.initials: JC
authors.lastname: Trullas
authors.forename: Piedad
authors.initials: P
authors.lastname: Arazo
authors.forename: José R
authors.initials: JR
authors.lastname: Arribas
authors.forename: Guillermina
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authors.lastname: Barril
authors.forename: Miguel
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authors.lastname: Cervero
authors.forename: Frederic
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authors.lastname: Cofan
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Vicente
authors.initials: V
authors.lastname: Estrada
authors.forename: Xavier
authors.initials: X
authors.lastname: Fulladosa
authors.forename: María J
authors.initials: MJ
authors.lastname: Galindo
authors.forename: Silvia
authors.initials: S
authors.lastname: Gracia
authors.forename: José A
authors.initials: JA
authors.lastname: Iribarren
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.forename: Alberto
authors.initials: A
authors.lastname: Martínez-Castelao
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
authors.forename: María A
authors.initials: MA
authors.lastname: Mazuecos
authors.forename: Celia
authors.initials: C
authors.lastname: Miralles
authors.forename: Rosario
authors.initials: R
authors.lastname: Montañés
authors.forename: Eugenia
authors.initials: E
authors.lastname: Negredo
authors.forename: Rosario
authors.initials: R
authors.lastname: Palacios
authors.forename: María J
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.forename: Manuel
authors.initials: M
authors.lastname: Praga
authors.forename: Carlos
authors.initials: C
authors.lastname: Quereda
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Juan M
authors.initials: JM
authors.lastname: Santamaría
authors.forename: José
authors.initials: J
authors.lastname: Sanz
authors.forename: Jesús
authors.initials: J
authors.lastname: Sanz
authors.forename: José M
authors.initials: JM
authors.lastname: Miró
mesh_terms: D000465:Algorithms; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007677:Kidney Function Tests; D012017:Referral and Consultation; D051436:Renal Insufficiency, Chronic / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D012307:Risk Factors