Regular

urine and blood tests
can check the health of your kidneys

HIV AND THE KIDNEY

What do I need to know?

WHAT DO I NEED TO KNOW? 

30% of people living with HIV show signs that their kidneys are not working normally – this is higher than the general population, but this is not just as a result of the virus. Age, lifestyle, family history, medications and having other infections or chronic diseases all affect kidney health.

Why is this?

  • The prevalence of some traditional risk factors for kidney disease, especially smoking and heavy alcohol and recreational drug use, is higher among people living with HIV
  • High blood pressure and diabetes, which are both common in people with HIV, are also major risk factors for kidney problems
  • Some HIV and non HIV medications can weaken healthy kidneys
  • If you are living with hepatitis C this may affect your risk of developing kidney problems
  • Poorly controlled HIV can spread and multiply in kidney cells, causing kidney damage known as HIV-Associated Nephropathy or HIVAN (nephropathy is a medical word used to describe damage to the kidneys)

The good news is that people with HIV will have their kidneys regularly monitored, so even the earliest stages of kidney disease can be detected.

Talk to your healthcare team about:

  • Better lifestyle choices. There are many changes you can make to ensure your kidneys stay as healthy as possible
  • How well your HIV is managed. An undetectable HIV viral load will help reduce your risk of kidney complications
  • Your blood pressure and blood sugar level results. You can read our heart and diabetes pages to learn more about prevention and management
  • Whether your HIV medication is affecting how well your kidneys are working

Shared decision making with your healthcare team

More about the kidneys

MORE ABOUT THE KIDNEYS

The kidneys play a major role in health and wellbeing; they clear out waste from the body, maintain the fluid balance, regulate blood pressure and balance the levels of salt/minerals in the blood. If the kidneys stop working as well as they should they won’t carry out these roles correctly, which over time can cause serious health issues.

Regardless of HIV status, most bodily functions deteriorate gradually over a lifetime and the kidneys are no exception.

Can HIV cause kidney disease?

CAN HIV CAUSE KIDNEY DISEASE?

Kidney disease is more common in people living with HIV, but this is not just as a result of the virus. Age, lifestyle, family history, medications and having other infections or chronic diseases all affect kidney health.

The good news is that an undetectable HIV viral load will help reduce the risk of kidney disease and your healthcare team will regularly monitor how well your kidneys are working. Simple lifestyle changes can also help ensure your kidneys are well looked after as you get older.

Am I at risk?

You may be at an increased risk if:

  • You have any family members with kidney problems
  • You are Black African
  • You have a poor diet and/or not physically active
  • You drink a lot of alcohol and/or smoke
  • You use recreational drugs
  • You have high blood pressure and/or diabetes
  • Your HIV viral load (the amount of HIV in your blood) is not undetectable
  • You are living with hepatitis C infection
  • You are taking a lot of medications

Talk to your healthcare team about what lifestyle choices you can make to look after your kidneys and for your routine test results.

What if I am already living with kidney disease?

Kidney disease in those living with HIV can be well-managed and you may be referred to see a kidney specialist for additional advice. Treatment options can vary considerably, depending on the cause (or causes) of a person’s kidney disease and any other health issues.

Some treatment possibilities include:

  • Reviewing lifestyle choices: changing your diet, doing more exercise and cutting down on alcohol, smoking and recreational drug use can help reduce risk of kidney disease and assist in lowering blood pressure
  • Reviewing HIV medications: some HIV medications are broken down (eliminated) by the kidneys and may lead to further kidney problems
  • Reviewing other medications you are taking as these might affect how your kidneys are working

Talk to your healthcare team about what changes you can make and if you have any concerns about how your medicines might be affecting the health of your kidneys.

Talk to your healthcare team about what changes you can make and if you have any concerns about how your medicines might be affecting the health of your kidneys.

What should I ask?

WHAT SHOULD I ASK?

  • What is my risk for kidney problems?
  • How well are my kidneys working?
  • Have my kidneys become worse over time?
  • Can you explain how HIV medications may affect my kidneys?
  • Since I developed kidney disease, how would my treatment regimen change?
  • What lifestyle changes could I make to look after my kidneys?
  • What are the signs of kidney problems? Is there anything I could look out for/monitor myself?
10
Tips

TO LOOK AFTER YOUR HEALTH

  1. Eat a healthy, balanced diet
  2. Stay hydrated
  3. Be physically active
    As this can reduce risk of diabetes and maintain healthy blood pressure
  4. Don’t smoke
    Or look for ways to help you cut back
  1. Avoid drinking excessive amounts of alcohol
    Or ask for help to cut down
  2. Ask your healthcare team about your kidney function test results
  3. Ask your healthcare team how your HIV medication affects your kidneys
  1. Test for hepatitis C
    If tested positive, ask your healthcare team for treatment options
  2. Let your healthcare team know if you use steroids or street/recreational drugs
    And ask for help to cut down or stop
  3. Download apps that can help you monitor your health
    Such as recording your food habits or offer support to stop drinking