15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

CHANGING PATTERNS IN HIV CARE-OUTCOMES FROM A COMBINED HIV RENAL CLINIC

HIV Med 2009 Apr 1-3; 10(Suppl. 1):16 (abstract no. P5)

M Rayment, J Levy, M Nelson and R Jones
Chelsea and Westminster Hospital NHS Foundation Trust, London, UK

BACKGROUND: As the prognosis for individuals living with HIV has improved, there is an increased risk of the co-morbidities seen commonly in an ageing population – particularly renal disease. Late presenters are also frequently affected by renal dysfunction. In order to meet the needs of this cohort, we have introduced a monthly combined HIV renal clinic where patients are reviewed by an HIV physician and a renal consultant.

METHODS: The database was interrogated to reveal all attendances of the combined clinic following its first 12 months of inception. Demographics, reason for referral, previous renal diagnoses, renal parameters, further investigations and outcomes were recorded.

RESULTS: Of 80 given appointments, there were 53 attendances, pertaining to 37 individuals of whom three (<1%) were women. Mean age was 47 years (31–71). The majority were white European (81%). Over a third (38%) had a previous renal diagnosis. Half (49%) were exposed to tenofovir at the time of review. The majority (78%) were referred due to a raised Cr and reduced eGFR. On further investigation, 25 (68%) had proteinuria with a raised urinary protein:Cr ratio. Five (14%) required renal biopsy. Of those attending, almost two-thirds were found to have non-HIV/non-antiretroviral related causes of renal dysfunction at the time of review.

CONCLUSIONS: Renal pathology is common in individuals living with HIV. Providers of HIV care should be adept at recognizing those at risk of renal complications and aware of methods to detect, monitor, investigate and treat those affected. Given that the majority of diagnoses made in the combined HIV/renal clinic were unrelated to HIV or antiretroviral exposure, renal management should be provided with the support of an experienced renal physician in a combined clinic where available.

2009-04-01
P5

Copyright © 2009 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD