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Published on: April 9, 2014
Nephrotoxicity of HAART
Robert Kalyesubula1, Mark A Perazella
1Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampal, Uganda.
AIDS Research and Treatment
|August 24, 2011
Summary
Highly active antiretroviral therapy (HAART) can cause kidney damage. Early screening and management are crucial for HIV patients, especially those with chronic kidney disease (CKD), to prevent further renal dysfunction.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Highly active antiretroviral therapy (HAART) and other HIV treatments are linked to significant toxicities.
- Antiretroviral drugs can directly cause kidney damage (e.g., acute tubular necrosis, interstitial nephritis) or indirectly through drug interactions.
Purpose of the Study:
- To summarize antiretroviral drugs associated with nephrotoxicity.
- To emphasize risk factors, management, and prevention strategies for drug-induced kidney injury in HIV patients.
Main Methods:
- Literature review of antiretroviral drug-associated nephrotoxicity.
- Focus on tenofovir and protease inhibitors.
- Analysis of risk factors, clinical presentation, and management guidelines.
Main Results:
- HAART regimens can lead to various forms of renal dysfunction.
- Increased vigilance for nephrotoxicity is needed with rising HAART use and new indications like pre-exposure prophylaxis (PrEP).
- Specific antiretroviral drugs, notably tenofovir and protease inhibitors, are frequently implicated.
Conclusions:
- Clinicians must screen HIV patients for kidney disease, particularly those on high-risk regimens.
- Management of HIV patients with chronic kidney disease (CKD) requires careful drug selection and GFR-based dose adjustments.
- Early detection, systematic screening, and appropriate referrals are vital for optimal patient care and preventing nephrotoxicity.
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