Kidney Failure and Dialysis in Patients with Human Immune Deficiency Virus Infection
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Abstract
Patients with human immune deficiency virus (HIV) infection are at high risk for developing chronic kidney disease and kidney failure. Risk factors include race, HIV related factors such as low CD-4 count and high viral load and other comorbidities including diabetes, hypertension and cardiovascular disease. With highly active antiretroviral therapy (HAART) becomes widely available and accessible, the prognosis and survival of HIV infected patients on dialysis improve considerably. Current evidence suggests no difference in survival between patients who receive hemodialysis and peritoneal dialysis. For hemodialysis, there is very little risk in transmitting HIV in dialysis centers, therefore, the separation of patients and hemodialysis machine are not necessary. The dialyzer can also be safely reused multiple times. For peritoneal dialysis, there may be an increased risk for infection and hospitalization especially among patients who have been on antiviral therapy for only a short period of time, have low CD-4 cell count and high viral load.
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