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Why should I care about kidneys?
Nearly one in three HIV-positive people has abnormal kidney function. HIV and some medications used to treat it can contribute to kidney problems. In addition, high blood pressure and diabetes, major causes of kidney disease, are common among people of color (including Latinos and African Americans) infected with HIV. Latinos are more at risk for kidney failure that other races. Although it is not known why Latinos are more at risk, diabetes, high blood pressure, and access to health care play a part. Currently, 1 in 8 kidney failure patients living in the U.S. is Latino.
What do the kidneys do?
Your kidneys, bean-shaped organs located halfway up your back, remove waste products and excess water (eliminated as urine) from your blood. They also control various chemicals in your blood. When necessary, your kidneys release hormones to manage blood pressure, stimulate red blood cell production and process vitamin D, which protects your bones.
What is renal function?
People with two healthy kidneys have 100% renal function, which is more than you need. If renal function falls below 25%, serious problems can occur: Because the kidneys process many medications, including some HIV drugs, levels of these medications could remain dangerously high in the body, increasing the risk of side effects, including further kidney damage. Those who suffer total and permanent kidney failure (also known as end-stage renal disease, or ESRD) will need a kidney transplant or dialysis, a form of life support in which patients have a machine filter their blood on a regular basis.
Are there symptoms of kidney disease?
During the early stages of kidney disease, people usually don't feel sick. Your need to urinate may increase or decrease. You may have trouble concentrating or feel unusually tired. You may also experience darkened skin, cramps and swollen feet or hands.
What can I do to prevent or manage kidney disease?
- Prevent or control high blood pressure and diabetes. Ask your doc how.
- Ask your doctor about HIV treatment. HIV itself can cause kidney disease. HIV-associated nephropathy (HIVAN) occurs when HIV enters the kidneys and multiplies, causing damage. It's more common in African Americans, those with low CD4 counts and/or people with a family history of renal disease.
- Talk to your about kidney health. Doctors should screen for kidney disease as soon as a patient tests HIV positive and check kidney function every year in patients at risk for renal impairment. Those who develop kidney disease should also work with kidney specialists (nephrologists) to consult on treatment options and manage their health.
Quick Tips
To keep your kidneys in top shape:
- Get checked: Experts recommend that positive folks at higher risk for renal impairment get kidney function checked every year, even if everything seems fine. This includes those with hepatitis C, high blood pressure, diabetes, CD4 counts below 200 and/or viral loads above 4,000.
- Ask about labs: Talk to your doc about renal function checks, including a urine sample to look at protein, and blood tests of creatinine clearance, glomular filtration rate (GFR) and blood urea nitrogen (BUN).
- Watch blood pressure: If your pressure is higher than 130 over 80, your doc might recommend drug treatment and lifestyle modifications, such as reducing your sodium intake and exercising more.
- Control your weight: Being overweight is a major risk factor for diabetes and hypertension, the top causes of kidney disease. If you're overweight, talk with your doc about shedding pounds.
- Eat (and drink) smart: Drink at least eight glasses of kidney-flushing water a day, especially if you're on HIV meds. To fight diabetes and hypertension, eat a diet low in calories, fat and sodium, and high in fiber, vegetables, fruit and whole grains.
- Mind your meds: Some HIV meds, Chinese herbal therapies, antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to kidney side effects. Let your doctor know about everything you're taking.
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