Article Sidebar
Article Details
The author(s) retain copyright on work published by AOSIS unless specified otherwise.
Licensing and publishing rights
Author(s) of work published by AOSIS are required to grant AOSIS the unlimited rights to publish the definitive work in any format, language and medium, for any lawful purpose. AOSIS requires journal authors to publish their work in open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.
Read more here: http://creativecommons.org/licenses/by/4.0/.
The authors retain the non-exclusive right to do anything they wish with the published article(s), provided attribution is given to the applicable journal with details of the original publication, as set out in the official citation of the article published in the journal. The retained right specifically includes the right to post the article on the authors’ or their institution’s websites or in institutional repositories.
Previously published work may have been published under a different licence. We advise the community that if they would like to reuse the work to consult the applicable licence at article level.
Main Article Content
HIV and end-stage renal disease: Practical issues in management
Abstract
According to UNAIDS data there are 40 million HIV-infected people around the globe. An uncommon complication of HIV is HIV-associated nephropathy (HIVAN), and this condition is expected to be one of the leading causes of end-stage kidney disease (EKD) in black men in the new millennium. Patients present with an immune complex glomerulopathy and focal segmental glomerulosclerosis together with proteinuria and haematuria and occasionally severe hypertension. Peripheral oedema is unusual. In the era before antiretroviral therapy (ART) the median survival in the HIV-infected population on dialysis
was 10 months. However, since the introduction of highly active antiretroviral therapy (HAART) and optimal prevention of opportunistic infections, a life expectancy of 10 - 20 years can be expected. Unfortunately patients infected with HIV are often excluded from renal replacement therapy (RRT) programmes despite such encouraging outcomes and despite the fact that the outcome of renal transplantation in HIV patients is comparable to that in HIV-negative recipients at 1-year follow-up in experienced centres. In the South African context HIV/AIDS has an alarming prevalence, although dialysis and transplantation
are offered only to very few and often only in the acute state. In the light of the new data, HIV seropositivity (especially when the patient is receiving HAART) needs to be reconsidered as an absolute contraindication to renal replacement.
Southern African Journal of HIV Medicine Vol. 7 (1) 2006: pp. 39-43
