If you’re living with HIV, your kidneys will have to be regularly tested for possible damage from HIV medicine and issues like high blood pressure.
The original formulation of the NRTI antiretroviral tenofovir (found in the combination drugs Truvada, Atripla and Eviplera) was linked to impaired kidney function, but the new formulation of the drug which has replaced it appears not to have the same effects.
The earlier formulation of the drug, tenofovir disoproxil fumarate (TDF) is the version that was linked to possible kidney impairment - but this was rare and reversed when the patient stopped taking the drug. The new version, tenofovir alafenamide (TAF) has been shown to cause less kidney toxicity than TDF, and people switching to the new drug have shown improvements in kidney function.
The protease inhibitors: atazanvir, lopinavir (found in Kaletra) and the rarely-used indinavir have been linked to kidney stones. These are crystals which form inside the kidney, over time forming a ‘stone’. The stones can cause pain when the body tries to pass them out through the bladder.
Most people with HIV will be offered regular kidney function tests.
Tests often look for protein in the urine, as it should only be found in the blood. They also look for creatinine, a waste product, in the blood. If the levels of creatinine are high, the kidneys are having trouble removing it (creatinine should be found in the urine rather than the blood). High blood pressure and diabetes can be picked up in routine tests and may be a sign of kidney damage.
If kidney problems become more serious, they might require dialysis – a filtering of waste products from the blood. It’s also possible to have a kidney transplant if necessary - having HIV doesn’t exclude you from this.
Chronic kidney disease (CKD) is when other conditions such as high blood pressure and diabetes put strain on the kidneys.
This leads to a gradual loss of kidney function, which can result in kidney failure. This is because diabetic people may have high glucose levels in their blood which can damage the kidneys' nephrons (part of the kidneys’ filtration system). High blood pressure can put strain on the blood vessels which surround the nephrons, causing damage.
HIV can cause specific kidney damage known as ‘HIV associated nephropathy’ (HIVAN) where the kidneys become enlarged.
HIVAN tends to be more common in African people or people of African descent. Usually HIVAN improves on antiretroviral treatment, which is why it’s much less common now.
Similarly CKD seems to be more prevalent among south Asian and black people. This is probably because there are higher rates of diabetes in south Asian people and higher rates of high blood pressure among black people.
Most people have two kidneys, located on each side of the spine towards the back of the abdomen (although many people function with just one).
Kidneys filter toxins and waste products from the blood, which are then converted into urine and expelled from the body via the bladder. Kidneys also release hormones to regulate blood pressure and the production of red blood cells, as well as helping the body to absorb calcium.
The Health Wealth and Happiness Project supports the financial, emotional and physical wellbeing of over 50s living with HIV in Brighton and London.
Next: Memory problems ››
‹‹ Back to: Heart problems
(No votes cast)
Please log in
or register to vote.
to add this article to My favourites.
Adding an article to My favourites will allow you to easily come back to it later or print it.
You will need to be logged in before you can leave a comment.
Please log in using the form on the top right of the page or register.
This article was last reviewed on
by Anna Peters
Date due for the next review: 2/1/2021
Content Author: Kerri Virani
Current Owner: Health promotion
Blood pressure and kidney disease
Kidney Research UK
Kidney Research UK
Prevalence of chronic kidney disease in South Asian and Black minorities: findings from a population based screening study in London, UK
Roderick P, Lightstone L, Harris S, et al
Journal of Epidemiology & Community Health 2009;63:64
Black and Asian kidney health
TAF as a replacement for tenofovir
Kidney toxicity including kidney stones (renal toxicity)
Lopinavir/ritonavir – Kaletra
HIV, ARVs and kidney impairment
Chronic kidney disease and HIV
The kidneys, a basic guide
Kidney Research UK
HIV and Chronic Kidney Disease National Kidney Foundation (2008)
Tenofovir treatment impairs kidney function, but clinical significance limited NAM aidsmap (2010)
The kidneys NAM aidsmap (2011)
HIV and the kidneys NAM aidsmap (2010)
Kidney disease in people with HIV: a clinical review (part one) NAM aidsmap (2011)
Kidney stones NHS June 2014
Vitamin D and Kidney Disease DaVita April 2009
HIV-associated nephropathy: a diagnosis in evolution Patricio E. Ray Nephrology, Dialysis, Transplantation Journal March 5, 2012
Chronic Kidney Disease - Overview NHS Choices March 2013
Tenofovir (Viread) - Side effects - Kidney toxicity NAM aidsmap March 2011
Tenofovir (Viread) NAM aidsmap March 2011
Indinavir (Crixivan) - Side effects NAM aidsmap March 2011
HIV. ARVs and kidney impairment NAM aidsmap March 2011
Ken talks about growing older with HIV.
CAB - Citizens Advice Bureau
HIV Drug Interactions
George House Trust
Equality and Human Rights Commission
Copyright 2018 © Terrence Higgins Trust is a registered charity in England and Wales (reg. no. 288527)
Company reg. no. 1778149 and a registered charity in Scotland (reg. no. SC039986). Registered office: 314-320 Gray's Inn Road, London, WC1X 8DP.