The guidelines are the first of their kind. They recommend screening for kidney disease at the time of HIV diagnosis to identify early this serious complication of HIV infection.
Nearly one-third of HIV-infected patients have abnormal amounts of protein in the urine, a warning sign of potential kidney trouble. HIV-related nephropathy (HIVAN) is joining diabetes, hypertension, and hepatitis C infection on the list of common conditions requiring dialysis. Also, kidney disease may be associated with progression to AIDS and death.
The guidelines are targeted toward HIV caregivers, who often manage all aspects of their patients' care and are therefore in a unique position to identify early those patients at risk for kidney disease. They provide an overview of how to identify patients at risk and evaluate their kidney function, as well as management strategies and other issues.
Samir K. Gupta, MD, MS, lead author of the new guidelines, says, "We're trying to shift gears from how you treat the HIV-infected patient with severe kidney disease, to how do we look for the ones who are at risk of developing severe kidney disease and taking care of them early so they don't have to end up going on dialysis."
According to the guidelines, those at high risk of kidney disease include people of African descent, those with low CD4+ cell counts or high viral loads, and people with diabetes, hypertension, or hepatitis C coinfection. All patients diagnosed with HIV should be screened for proteinuria and kidney function.
"One of the major goals of the guidelines is to say we need to be doing screening for patients at higher risk, and if these patients are at higher risk for conditions like HIVAN, then perhaps we should be tr
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Contact: Steve Baragona
sbaragona@idsociety.org
703-299-0412
Infectious Diseases Society of America
27-Apr-2005