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Kidney problems and HIV

facts and figures

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.

Symptoms of kidney problems can include:

  • tiredness
  • nausea
  • swollen ankles or feet
  • frequent urination (especially at night).

Does HIV treatment cause kidney problems?

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.

Will I have to have extra tests to check the health of my kidneys?

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.

What is chronic kidney disease?

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.

What is HIV associated nephropathy (HIVAN)?

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.

What do kidneys do?

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.

Over 50 and living with HIV?

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



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The Information Standard: Certified member

This article was last reviewed on 2/1/2018 by Anna Peters

Date due for the next review: 2/1/2021

Content Author: Kerri Virani

Current Owner: Health promotion

More information:

NAM Aidsmap

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
NHS Choices

Kidney stones
NHS Choices

TAF as a replacement for tenofovir
NAM Aidsmap

Kidney toxicity including kidney stones (renal toxicity)

Lopinavir/ritonavir – Kaletra
NAM Aidsmap

HIV, ARVs and kidney impairment
NAM Aidsmap

Chronic kidney disease and HIV
Roger Pebody
NAM Aidsmap
February 2017

The kidneys, a basic guide
Kidney Research UK

HIV and Chronic Kidney Disease
National Kidney Foundation

Tenofovir treatment impairs kidney function, but clinical significance limited
NAM aidsmap

The kidneys
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HIV and the kidneys
NAM aidsmap

Kidney disease in people with HIV: a clinical review (part one)
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Kidney stones
June 2014

Vitamin D and Kidney Disease
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)
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March 2011

Indinavir (Crixivan) - Side effects
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March 2011

HIV. ARVs and kidney impairment
NAM aidsmap
March 2011