Monitoring of kidney function in older people living with HIV.
(2018) HIV medicine — Vol. 19, n° 2, p. e51 (2018)
Files
2018_Post_HIVMed.pdf
Restricted Access - Adobe PDF
- 30.72 KB
Details
- Authors
- Abstract
- We would like to thank Musso and Belloso for their insightful comments on the effects of ageing on estimated glomerular filtration rate (eGFR). Ageing is an important risk factor for chronic kidney disease (CKD) associated with cardiovascular disease, hypertension and diabetes 1. The prevalence of these CKD risk factors is increased in older people living with HIV 2, and polypharmacy is common 3. Consequently, many older patients with HIV infection may benefit from more frequent monitoring of renal function. We agree with Musso and Belloso that annual monitoring of renal function is probably sufficient for elderly patients with eGFR ≥45 mL/min/1.73 m2 who have stable renal function, normal urinalysis and an expected eGFR < 60 mL/min/1.73 m2 based on Keller's equation (130 − age), provided that their antiretroviral regimens do not include tenofovir (TDF) and/or atazanavir 4. We also concur that older patients with stable eGFR and moderate proteinuria (protein:creatinine ratio 50−100 mg/mmol) are likely to benefit from more frequent monitoring (i.e. every 6 months). Importantly, old age should not preclude patients with rapid eGFR decline (>5−10 mL/min/1.73 m2/year) and those with severe proteinuria or haematuria from being referred for diagnostic evaluation, and patients with eGFR <30 mL/min/1.73 m2 and bland urinalysis being referred in preparation for renal replacement therapy. [...]
- Affiliations
Citations
Post, F. A., Yombi, J. C., & Hougardy, J.-M. (2018). Monitoring of kidney function in older people living with HIV. HIV medicine, 19(2), e51. https://doi.org/10.1111/hiv.12396 (Original work published 2018)