Executive summary of the consensus document on the management of renal disease in HIV-infected patients.

José Luis Górriz, Félix Gutiérrez, Joan Carles Trullas, Piedad Arazo, Jose Ramón Arribas, Guillermina Barril, Miguel Cervero, Frederic Cofan, Pere Domingo, Vicente Estrada, Xavier Fulladosa, Maria José Galindo, Silvia Gracia, Jose Antonio Iribarren, Hernando Knobel, Jose Lopez-Aldeguer, Fernando Lozano, Alberto Martínez-Castelao, Esteban Martinez, Maria A Mazuecos, Celia Miralles, Rosario Montañes, Eugenia Negredo, Rosario Palacios, María Jesús Pérez-Elías, Joaquin Portilla, Manuel Praga, Carlos Quereda, Antonio Rivero, Juan M Santamaria, Jose Sanz, Jesús Sanz, José María Miró

The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in HIV-infected patients. Renal function should be monitored in all HIV-infected patients. The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glucosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document provides indications for renal biopsy and advises on the optimal time for referral of a patient to the nephrologist. The indications for and evaluation and management of dialysis and renal transplantation are also addressed.