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The potential renal toxicities of antiretroviral drugs usually manifest as clinically apparent acute kidney injury. However, the kidney effects of the HIV infection, and of comorbidities such as diabetic nephropathy and hypertensive nephrosclerosis, are far more insidious in their onset and progression. The less obvious the onset and progression are, the more important the role that screening can play in early detection, early treatment decisions, and prevention of serious consequences such as end-stage renal disease and the need for dialysis.
The paradigm for clinicians to use in monitoring the kidney function of HIV-infected patients (measuring serum creatinine levels and proteinuria) is similar to that used in monitoring their immune syst…