Kidney disease in patients with HIV.

Meghan E Sise, Sherley M Mejia, Clara J Fischman

Journal: Current opinion in HIV and AIDS 2025;20(4):359-364

PMID: 40184511

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Abstract

PURPOSE OF REVIEW

With the advent of antiretroviral therapy, people with HIV (PWH) are living longer and are at risk of developing age-related comorbid illnesses, such as chronic kidney disease (CKD). The purpose of this review article is to summarize recent advances in the diagnosis and management of kidney disease in PWH, and ultimately inform clinical practice.

RECENT FINDINGS

Individuals of West African descent are often genetically predisposed to develop CKD. Among carriers of the APOL-1 risk variant, Na + /K + transport has been identified as the proximal driver in APOL-1-mediated pathogenesis. The use of urine biomarkers in CKD diagnosis among PWH has been supported and is comparable to the general population. Additionally, novel CKD therapies, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists can potentially offer significant clinical benefit to PWH with CKD.

SUMMARY

Despite being an underrepresented group in clinical trials, recent research findings have broadened our understanding of kidney disease in PWH. Given that PWH experience an increased risk of developing CKD, early detection and management is vital in improving quality of life and overall healthcare outcomes.

Address: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.; Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

DOI: 10.1097/COH.0000000000000941