Risk factors associated with an increased risk of CKD are well recognised. Some of these are modifiable, emphasising the importance of their early detection and management19. Renal risk factors may be specific to patients with HIV; other ‘traditional’ renal risk factors have overlap with those seen in the HIV non-infected patient group, as shown in Table 120,21. It is important to consider an individual patient’s overall risk of renal disease at the time of diagnosis, and to modify their ART and subsequent monitoring accordingly, though even patients on non-nephrotoxic ART remain at high risk of renal disease21.
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Table 1. Risk factors for renal disease in patients with HIV infection (adapted from Estrella et al20 and Lucas et al21) |
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TRADITIONAL RISK FACTORS · Older age · Hypertension · Diabetes · Obesity · Cigarette smoking · Co-infection with hepatitis C virus and/or hepatitis B virus · APOL-1 risk alleles HIV-SPECIFIC RISK FACTORS · Some antiretroviral drugs · Low CD4+ T cell counts · High HIV viral load · History of AIDS-defining illness |