Kidney Disease

Apart from common causes of kidney disease like diabetes and high blood pressure, people with HIV have additional risk factors for kidney disease. HIV itself, or the inflammation it causes, can damage the kidneys, even if the viral load is undetectable. Certain HIV medications can also decrease kidney function.

WHAT HAPPENS WHEN YOU HAVE KIDNEY DISEASE?

Kidneys filter waste products out of the blood and make urine. They also control blood pressure and keep your body chemicals in balance. When the kidneys are damaged, blood pressure can get so high that it damages other organs, like the heart or the brain. This can cause heart attacks or strokes, leading to decreased function or death. A buildup of waste or chemicals can cause confusion, bone problems, or death.

What you can do with your doctor

TALK TO YOUR DOCTOR IF YOU HAVE DIABETES OR HIGH BLOOD PRESSURE

People with high blood pressure or diabetes should be checked regularly for kidney disease, since these conditions can damage the kidneys. Work with your doctor to keep them under control.

ASK IF YOU NEED TO CHANGE OR STOP SOME OF YOUR MEDS

Kidneys filter the unwanted chemicals from your meds and pass them out of your body as urine. If your kidneys are damaged, you may need to change your meds or change the dose to prevent a toxic buildup. Bring all your pill bottles to your doctor, including over-the-counter and herbal pills. Sit down with your doctor and go through them one by one, to see if you need to change any of them. Any time you start a new med or alternative treatment, be sure to discuss it with your doctor.

 

Ask your doctor exactly which over-the-counter meds you should avoid. For example, most people with reduced kidney function should not take drugs like aspirin, ibuprofen, Advil, Motrin, or Aleve. Ask your doctor which pain meds are right for you.

 

TALK TO YOUR DOCTOR BEFORE YOUR KIDNEY DISEASE WORSENS

In some cases, kidney function can worsen to the point where the kidneys are unable to function. When this happens, people may need to go on dialysis (using a machine to filter the blood) or get a kidney transplant. Plan and talk to your doctor early about your options. Bring a friend or family member you trust who can help you decide what to do if your kidneys get worse.

What you can do yourself

TAKE PILLS CORRECTLY

Take the right number of pills at the right time of day. This is especially important for people with kidney disease. Uncontrolled HIV, blood sugar, or blood pressure can damage your kidneys. Also, the right pills will keep your chemicals balanced and prevent you from feeling ill. If you have reduced kidney function, alert any new doctor you see, since the dose of many medications may need to be adjusted.

EAT A BALANCED DIET

If you eat a lot of salt or protein, the kidneys must work harder to filter them out. To protect your kidneys, eat a low-salt diet with the right amount of proteins. To plan a diet that is easier on your kidneys, see a nutritionist.  Ask your physician if a multiple vitamin or mineral supplement is right for you.

 

A Sangarlangkam MD, R Havlik MD, S Karpiak PhD, J Appelbaum MD. Staying Healthy with HIV as You Age (2016). Published by the AAHIVM HIV Aging Consensus Project

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