Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
As medical science advances, patients with the human immunodeficiency virus (HIV) are living longer, which increases their risk for developing chronic kidney disease (CKD). While CKD can be prevented or delayed by early diagnosis and treatment, it remains under-diagnosed and under-treated in HIV patients.
This is why the National Kidney Foundation (NKF) has recently launched an education program designed to raise awareness of the growing problem of chronic kidney disease (CKD) in patients with human immunodeficiency virus (HIV) among clinicians and HIV treatment educators.
With estimates ranging from seven to thirty percent of patients with HIV potentially having CKD, the goal of the program is to educate clinicians and HIV treatment educators on the risk factors for CKD and best practices to screen for and monitor kidney function.
"The relationship between HIV and CKD is very important for clinicians to address early in patients with HIV and there is a need for resources to help clinicians connect HIV with an increased risk for CKD," said Leslie Spry, MD, FACP, FASN, Chairman of the Kidney Learning System Editorial Board, National Kidney Foundation. "HIV treatment educators also play a pivotal role in the care of patients with HIV, which is why we developed resources specifically tailored to their needs and the needs of the patients they work with."
The HIV and CKD educational program consists of new educational toolkits tailored for the use of HIV clinicians and treatment educators. The toolkit for clinicians includes a patient brochure to help explain the complexities of HIV and CKD, a guide explaining the benefit and use of glomerular filtration rate (GFR) to screen for CKD in HIV patients, a GFR prediction calculator, and a laminated pocket reference tool to help clinicians quickly identify, monitor and manage CKD in HIV patients.
The toolkit for HIV treatment educators, who are critical to providing education to HIV patients through grassroots AIDS Service Organizations and clinics, includes a patient brochure and a guide to understanding GFR.
HIV and Chronic Kidney Disease
Chronic kidney disease (CKD) is defined as either the presence of kidney damage or GFR less than 60 mL/min/1.73 m2 for three or more months. At the time of initial HIV diagnosis, it is recommended that patients be screened for existing kidney disease using the serum creatinine level to estimate the glomerular filtration rate (GFR) and evaluate for proteinuria (protein in the urine) to assess for kidney damage. If there is no evidence of CKD in newly diagnosed patients with HIV, those at high risk of developing kidney disease (e.g., patients with diabetes, hypertension, those who are African-American or those with hepatitis C) should be screened annually.