HIV and Kidney Disease
Description Referral N04.9/N05.9/N17.9 + (B24) DESCRIPTION Various forms of kidney disorders are described among PLHIV. Early detection of HIV kidney disease may be beneficial in an attempt to protect the kidney from further disease progression and for adjusting the dose of relevant medicines (See: Antiretroviral therapy, adults table - Antiretroviral medicines: Dose and common adverse dru
N04.9/N05.9/N17.9 + (B24)
DESCRIPTION
Various forms of kidney disorders are described among PLHIV.
Early detection of HIV kidney disease may be beneficial in an attempt to protect the kidney from further disease progression and for adjusting the dose of relevant medicines (See: Antiretroviral therapy, adults table - Antiretroviral medicines: Dose and common adverse drug reactions).
Screen all patients for renal disease at time of HIV diagnosis.
Patients at high risk or susceptible for HIV renal disease include:
- CD4 count < 200 cells/mm3.
- History of nephrotoxic medications.
- Comorbidity such as diabetes mellitus, hypertension, or hepatitis C virus coinfection.
Screening for renal disease in HIV
- Tests should include:
- Urine dipstix for haematuria and proteinuria.
- Serum creatinine and eGFR.
- If there is no evidence of kidney disease at the initial evaluation, repeat screening annually.
- In patients receiving tenofovir, monitor creatinine/eGFR at month 3, month 10, and every 12 months thereafter. Align with VL monitoring schedule.
REFERRAL
- Patients with persistent significant proteinuria (1+ or more).
- Unexplained haematuria on 2 consecutive visits
- Estimated eGFR < 60 mL/min.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare_V1.0_26 February 2026
Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV AND AIDS)_11.4 HIV and Kidney Disease