Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Kidney Int. 2018 Mar;93(3):545-559. doi: 10.1016/j.kint.2017.11.007. Epub 2018 Feb 3.


HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population. We convened an international panel of experts in nephrology, renal pathology, and infectious diseases to define the pathology of kidney disease in the setting of HIV infection; describe the role of genetics in the natural history, diagnosis, and treatment of kidney disease in HIV-positive individuals; characterize the renal risk-benefit of antiretroviral therapy for HIV treatment and prevention; and define best practices for the prevention and management of kidney disease in HIV-positive individuals.

Keywords: APOL1; CKD progression; HIV; antiretroviral therapy; immune complex kidney disease; podocytopathy; renal pathology.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • AIDS-Associated Nephropathy* / diagnosis
  • AIDS-Associated Nephropathy* / epidemiology
  • AIDS-Associated Nephropathy* / genetics
  • AIDS-Associated Nephropathy* / therapy
  • Anti-HIV Agents / adverse effects
  • Comorbidity
  • Diagnosis, Differential
  • Evidence-Based Medicine / standards
  • Genetic Predisposition to Disease
  • HIV* / drug effects
  • HIV* / genetics
  • HIV* / pathogenicity
  • Host-Pathogen Interactions
  • Humans
  • Kidney* / drug effects
  • Kidney* / pathology
  • Kidney* / virology
  • Nephrology / standards*
  • Predictive Value of Tests
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / genetics
  • Renal Insufficiency, Chronic* / therapy
  • Risk Factors
  • Treatment Outcome


  • Anti-HIV Agents