Kidney disease includes conditions that damage your kidneys or interfere with the filtering job of your kidneys. Symptoms of kidney disease include:

• Loss of energy
• Shortness of breath
• Dehydration
• Excessive urination
• Excessive thirst
• Quick heart rate
• Diabetes

If you are experiencing any of these symptoms, it is important to contact your healthcare provider. If left untreated, kidney disease can become very serious and eventually lead to kidney failure.

Causes of Kidney Disease in People With HIV

Kidney disease may be caused by HIV infection itself. A low CD4 cell count or advanced HIV disease can increase your chances of kidney disease. Research has shown that as your CD4 cell count decreases, your kidneys sometimes begin to lose their ability to work correctly. Over time, this can result in kidney disease or even kidney failure. People at a high risk for kidney disease include people with HIV and:

• With diabetes
• With high blood pressure
• With a family history of kidney disease
• Of African descent or who are Native American, Hispanic, or Pacific Islander
• With CD4 cell counts below 200
• With viral loads above 4000
• With hepatitis C
• Who are older
• Who use medicines that may affect the kidneys

Certain HIV drugs can also cause kidney damage in some people with HIV. In addition, special types of antibiotics used to treat PCP, a dangerous form of pneumonia, have also been linked to kidney damage and kidney stone formation.

Diagnosis There are simple blood and urine tests that your healthcare provider can perform to check for kidney disease. If you do test HIV+, the Infectious Diseases Society of America recommends a test for kidney disease at the time of diagnosis. If kidney disease runs in your family or you are at high risk for kidney disease, you should continue to be tested for kidney disease every year following your HIV diagnosis.

Treatment of Kidney Disease

Treatment for kidney disease depends on the cause. There are some medications available that can help. However, if your kidney disease is bad enough, you may need dialysis. Dialysis involves the use of a machine, instead of your kidneys, to help filter waste and other toxins from your blood. In the most severe cases, kidney transplants may also be performed.

Treatment of Kidney Disease in People With HIV

How to best treat people with HIV with kidney disease remains unclear. Talk to your healthcare provider about HIV treatment options that are right for you.