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Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease I: Introduction01:25

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Acute Kidney Injury I: Introduction01:22

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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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HIV-associated kidney diseases: progress, gaps, and future directions.

Molly C Fisher1, Christina M Wyatt2, Michelle M Estrella3

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Clinical Microbiology Reviews
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Summary

Chronic kidney disease (CKD) in people with HIV (PWH) has shifted from HIV-driven causes to age-related conditions like diabetes and hypertension. Early detection and new therapies are crucial for managing CKD and cardiovascular risks in PWH.

Keywords:
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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Antiretroviral therapy (ART) has transformed HIV care, reducing HIV-associated nephropathy (HIVAN).
  • Chronic kidney disease (CKD) is now a significant comorbidity in people with HIV (PWH) due to aging and conditions like diabetes and hypertension.
  • CKD management in PWH is complex, especially in low-resource settings with co-infections and limited screening access.

Purpose of the Study:

  • To review the current understanding of kidney diseases in people with HIV (PWH).
  • To discuss the evolving epidemiology, pathogenesis, diagnosis, and management of CKD in the context of modern HIV care.
  • To highlight the importance of early CKD detection and management for preventing progression and cardiovascular complications.

Main Methods:

  • Literature review of recent studies on kidney disease in people with HIV (PWH).
  • Analysis of epidemiological trends, treatment advancements, and management strategies.
  • Synthesis of information on diagnosis, pathogenesis, and outcomes, including kidney transplantation.

Main Results:

  • HIV-associated nephropathy (HIVAN) has decreased with widespread ART availability.
  • Age-related conditions (diabetes, hypertension) are now primary drivers of CKD in PWH.
  • New therapies show promise in reducing CKD progression and cardiovascular events.
  • Kidney transplantation offers improved survival for PWH with end-stage kidney disease.

Conclusions:

  • CKD remains a critical issue for people with HIV (PWH), driven by comorbidities.
  • Early detection, risk factor management, and timely intervention are essential for slowing CKD progression.
  • Ongoing research into contemporary ART regimens and novel therapies is needed to further reduce the burden of kidney disease in PWH.