Screening and monitoring HIV-positive people for CKD

摘要

Late in 2014 the HIV Medicine Association(HIVMA) updated its guidelines on screeningfor and managing chronic kidney disease in adultsand children with HIV. These HIV kidney expertsrecommend monitoring creatinine-based estimatedglomerular filtration rate (eGFR) when antiretroviraltherapy begins or changes and at least twice yearly inpeople with stable HIV infection. These guidelines,plus advice from the New York State Department ofHealth AIDS Institute and other authorities, also offerstraightforward guidance on managing CKD inadults and children with HIV, how to evaluate peoplewith borderline GFR, when to refer HIV CKD patientsto a nephrologist, which GFR estimating equationsto use, which antiretrovirals and other medicationsneed dose adjustments in people with decliningkidney function, and an array of other clinical topics.