Possible Complications

Common complications associated with chronic kidney disease (CKD) include:

  • hypertension, both a cause and complication of CKD
    • if uncontrolled (target of <130/80mmHg, or <125/75mmHg if proteinuria >1g/24hrs) hypertension is associated with increased risk of progression of kidney disease and increased risk of coronary heart disease
  • substantial abnormalities in lipid metabolism
    • the total target cholesterol value should be <4.0mmol/L, with low-density lipoprotein (LDL) <2.5mmol/L
  • mineral and bone disorders associated with changes in metabolism of calcium, phosphate, parathyroid hormone and vitamin D
     

Further complications may arise in HIV-infected patients who require kidney transplantation, from drug interactions and a complex set of possible infectious, metabolic and neoplastic conditions. Clinical management should therefore be provided by a multidisciplinary team able to identify and appropriately deal with any evolving signs, symptoms and laboratory abnormalities.2 



HIV-infected patients with CKD also develop abnormalities in calcium and phosphate metabolism in the same way that HIV-negative patients do.1–3






References

  1. Kidney Health Australia. Chronic kidney disease management in General Practice. Accessed 1 March 2011. 
  2. Gupta SK, Eustace JA, Winston JA, et al. Guidelines for the Management of Chronic Kidney Disease in HIV-Infected Patients: Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2005;40:1559–1585. 
  3. Cockerell CJ, Dolan ET. Widespread cutaneous and systemic calcification (calciphylaxis) in patients with the acquired immunodeficiency syndrome and renal disease. J Am Acad Dermatol. 1992;26:559–562.