Kidney Function and Disease
Your kidneys filter extra water and wastes out of your blood and make urine. They also help control your blood pressure and make hormones that your body needs to stay healthy.
If your kidneys don’t work properly, harmful waste products can build up in your body and cause serious health problems. Untreated kidney problems can be fatal.
Are You at Risk?
You are more likely to develop kidney disease if you:
- Are African American
- Have diabetes
- Have high blood pressure
- Are older
- Have a lower CD4 count (below 200 cells/mm3)
- Have a higher viral load
- Have Hepatitis B or Hepatitis C
For more information, see the National Kidney Disease Education Programs’ About Kidney Disease.
Signs and Symptoms
Unfortunately, early kidney disease has no symptoms. If your kidneys are not working properly, they may suffer serious damage before you begin experiencing problems. That’s why it’s so important for your healthcare provider to test your kidney function on a regular basis.
A urinalysis is the most common test used to check kidney function. Your healthcare provider will order this test to check your urine for a number of things, including protein, ketones, and sugar. Protein in your urine is a sign that your kidneys are not working the way they should. Ketones and sugar in your urine are markers for diabetes—a major cause of kidney disease.
What Role Does HIV Play in Kidney Disease?
Kidney disease is common in people living with HIV/AIDS—up to 30% have abnormal kidney function. HIV can affect your kidneys in many different ways, but the most common are HIV-associated nephropathy and nephrotoxicity.
HIV Associated Nephropathy (HIVAN)
HIVAN occurs when your kidneys are damaged by the Human Immunodeficiency Virus (HIV) itself. While you can experience HIVAN at any stage of your HIV infection, it is most common in patients with CD4 counts less than 200 cells/mm3. African American men with HIV/AIDS seem to be most at risk for developing this complication.
If you have HIVAN, antiretroviral therapy is one of the most effective treatments.
The term means “toxic or destructive to the kidneys.” For people living with HIV/AIDS, nephrotoxicity can be a side effect of certain HIV medications, including protease inhibitors and nucleoside reverse transcriptase inhibitors (NRTIs—commonly called “nukes”).
Your kidneys clear many medications from your body—so if they aren’t working properly, your healthcare provider will need to adjust the amount of medication (including your HIV meds) that you are taking.
For more information, see The Body’s HIV and Kidney Disease .
Fact Sheets & Print Materials
- National Kidney Disease Education Program – Diabetes and High Blood Pressure: Make the Kidney Connection
- National Library of Medicine - Kidney Failure
- University of California, San Francisco – HIVInSite: Renal Manifestations of HIV
- HRSA – A Guide To Primary Care For People With HIV/AIDS, 2004 edition: Renal Disease
- AIDSinfo – Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
- Guidelines for the Management of Chronic Kidney Disease in HIV-Infected Patients: Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America
Last revised: 07/30/2009