How is kidney disease first detected in patients with HIV?
Standard recommendations for screening HIV patients have been established and require a measurement of kidney function (creatinine and glomerular filtration rate [GFR] calculation), urine dipstick with microscopy, and a urine protein to creatinine ratio at the time of initial evaluation.
This is repeated annually, or more often, depending on whether the patient has risk factors for kidney disease, such as exposure to nephrotoxic drugs or co-morbidities including hypertension, diabetes, or concurrent hepatitis C (HCV) or B (HBV).
It is not necessary to measure the GFR by 24-hour urine collections; it can be accurately estimated glomerular filtration rate (eGFR) from the creatinine level using conventional estimating formulas.
The standard National Kidney Foundation and Kidney Disease: Improving Global Outcomes (KDIGO) definitions for CKD should be applied to patients with HIV as well as the Acute Kidney Injury Network definition of AKI.
