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Kidney Disease in HIV - Changing Face Reflcting Growing Burden of Comorbid Disease in Aging HIV+ Population
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"available data suggest that both HIV infection and cART nephrotoxicity continue to contribute to the increased risk of chronic kidney disease in HIV-infected individuals in the United States and Europe......... With the widespread use of cART, HIVAN is increasingly rare in populations with access to care, and the spectrum of HIV-related chronic kidney disease now reflects the growing burden of comorbid disease in the aging HIV population.....With expanding access to cART and Westernization of the diet in many African nations, it is likely that diabetes and hypertension will have an increasingly important role in the future."
from Jules: it is important to connect with a nephrologist, a kidney expert in HIV & kidney disease
"Diabetes and hypertension account for more than 70% of all ESRD in the general US population.......With aging of the HIV-infected population and prolonged exposure to cART regimens that may promote the development of diabetes and hypertension, the prevalence of comorbid CKD risk factors is increasing. Two longitudinal studies have suggested an additive effect of HIV infection and diabetes in promoting CKD progression in the US veteran population"
"Clinicians will need to counsel patients on the risk of kidney disease with long-term therapy......healthcare providers should minimize the morbidity and mortality associated with CKD by implementing routine CKD screening, aggressively managing comorbid conditions, and among persons with CKD, avoiding nephrotoxic agents and referring early to a nephrologist"
"Illicit drug abuse is an independent risk factor for chronic kidney disease.....Illicit drug abuse is associated with a broad but unspecific spectrum of pathologic alterations of the kidneys. Cocaine abuse has a deleterious role in this setting by promoting hypertensive and ischemic damage."
Nephropathy in Illicit Drug Abusers: A Postmortem Analysis...."Illicit drug abuse is an independent risk factor for chronic kidney disease" - (09/02/15)
Kidney in HIV+ .......HIV viremia and changes in kidney function - (09/02/15)
Kidney disease in HIV ....changing epidemiology ....associated with aging/comorbid diseases including diabetes & hypertension not HIV - (09/02/15)
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