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Kidney Int. 2018 Mar;93(3):545-559. doi: 10.1016/j.kint.2017.11.007. Epub 2018 Feb 3.

Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Author information

1
Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. Electronic address: charles.swanepoel@uct.ac.za.
2
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
3
Department of Pathology & Cell Biology, Columbia University Medical Center, New York, New York, USA.
4
Department of Medicine, San Francisco VA Medical Center and University of California, San Francisco, California, USA.
5
Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, Tennessee, USA.
6
Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
7
King's College Hospital NHS Foundation Trust, London, UK.
8
Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
9
Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical Research, Frederick National Laboratory, Frederick, Maryland, USA.
10
KDIGO, Brussels, Belgium.
11
University College London, London, UK.
12
Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
13
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: christina.wyatt@mssm.edu.

Abstract

HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population. We convened an international panel of experts in nephrology, renal pathology, and infectious diseases to define the pathology of kidney disease in the setting of HIV infection; describe the role of genetics in the natural history, diagnosis, and treatment of kidney disease in HIV-positive individuals; characterize the renal risk-benefit of antiretroviral therapy for HIV treatment and prevention; and define best practices for the prevention and management of kidney disease in HIV-positive individuals.

KEYWORDS:

APOL1; CKD progression; HIV; antiretroviral therapy; immune complex kidney disease; podocytopathy; renal pathology

PMID:
29398134
PMCID:
PMC5983378
[Available on 2019-03-01]
DOI:
10.1016/j.kint.2017.11.007
[Indexed for MEDLINE]
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