title: HIV and the kidney in the acute medical unit.
abstract: Acute kidney injury (AKI) is encountered commonly in HIV-positive patients admitted to the acute medical unit. The spectrum of AKI has changed in the era of combination anti-retroviral therapy, and now includes adverse effects of commonly used anti-retroviral drugs in addition to traditional precipitants such as severe sepsis or exposure to nephrotoxic antimicrobials. An accurate diagnosis requires careful integration of clinical data including volume status, history of potentially nephrotoxic exposures and consideration of immuno-virological status. This article provides an overview of common causes of AKI in HIV and presents a framework by which the acute care physician may approach the finding of an elevated serum creatinine in a patient with HIV.
authors.affiliation: UCL Centre for Nephrology, Royal Free Hospital NHS Foundation Trust, London, UK johnwrbooth@doctors.org.uk.
authors.forename: John W
authors.initials: JW
authors.lastname: Booth
authors.affiliation: King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Post
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D000069446:Atazanavir Sulfate / Q000009:adverse effects / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D000068698:Tenofovir / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D044966:Anti-Retroviral Agents; D000069446:Atazanavir Sulfate; D000068698:Tenofovir
keywords: AKI; ART; HIV; atazanavir; tenofovir