HIV and your kidneys

What is HIV? 

HIV, or human immunodeficiency virus, is a virus that attacks your immune system. Your immune system is the cells, tissues and organs that help your body fight infections. If you have HIV, your body is less able to protect you from infections and cancer.

HIV is spread through contact with body fluids of a person with HIV. 

There is no one cure for HIV, but there are medicines that can lower the amount of HIV in the blood (called the viral load). If a person's viral load is so low that it cannot be detected in their blood, they can live a healthy life and will not spread HIV.

How does HIV cause kidney disease?

HIV, and some HIV medicines, can cause kidney disease by harming glomeruli, which are the parts of the kidney that clean your blood, and tubules, which are the parts of your kidney that help keep your electrolyte levels balanced. When glomeruli do not work well, the kidneys cannot help your body get rid of harmful waste that can build up in your blood. HIV can also infect the cells in your kidneys.

If you have HIV, you have a higher chance of having problems related to your kidneys. This can include acute kidney injury (AKI), HIV-associated nephropathy (HIVAN), or kidney damage from medicines. Certain medicines used to treat HIV, such as antiretroviral therapy (ART), and medicines used to treat infections related to HIV can be harmful to the kidneys. These medicines can affect the kidneys' ability to work properly, leading to kidney damage and potentially kidney failure over time. If you have HIV talk with your doctor about these possible side effects from your medicines. While medicines can cause some kidney damage, the damage that from untreated HIV is typically worse than the side effects from the medicines. It is also important to have regular tests to monitor your kidney health and catch any problems early. 

How can I prevent HIV from causing kidney disease?

Many people with HIV do not get kidney disease. Here are some ways you can lower your chances, such as:

Have your kidneys tested with a blood test twice a year and a urine test at least once a year, especially if you:

• Have a large amount of HIV in your blood
• Have a low level of CD4 cells, which are blood cells that help fight HIV
• Are African American, Hispanic, Asian, Pacific Islander or Native American  
• Have diabetes, high blood pressure or hepatitis C
• Manage long-lasting (chronic) health problems  

Take your medicines as prescribed, especially your HIV medicines, and ask your doctor if there are other HIV medicines that are less likely to harm your kidneys. 

If you have diabetes, manage your blood sugar levels.  

Check your blood pressure as often as your doctor recommends and take steps to manage it if needed. Talk to your doctor about ways to keep it at a healthy level. 

Follow a kidney-friendly eating plan  

Talk with a dietitian to help you create a kidney-friendly meal plan just for you. A dietitian is someone with special training in food and nutrition.

Eat plenty of fruits, vegetables, whole grains and lean proteins. These good nutrients can help lower the chance of long-lasting (chronic) disease, such as kidney disease.  

Limit how much salt, sugar and processed foods you eat, which can be harmful to your kidneys over time.  

Maintain a healthy lifestyle

• Keep yourself physically active with at least 30 minutes of physical activity most days of the week
• Avoid smoking
• Limit your alcohol intake
• Manage stress effectively to maintain your well-being
• Make sure to stay well-hydrated by drinking enough water
• Avoid over the counter pain medicines like ibuprofen or naproxen since it can harm your kidneys  
• Maintain a healthy blood pressure and get checked regularly