Human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) offers many diagnostic and therapeutic challenges to nephrologists. Renal failure may be a direct consequence of viral infection (HIV-associated nephropathy), or intrinsic renal diseases may occur in previously infected individuals. Patients receiving renal replacement therapy (RRT) may acquire HIV infection from blood transfusions, renal allografts, sexual contacts, or needle sharing by drug addicts. In the early 1980s, the overall prognosis of patients with the acquired immunodeficiency syndrome (AIDS) was very poor, and survival of those with ESRD was dismal. Consequently many even questioned the value of providing maintenance dialysis to patients with AIDS. With advances in diagnostic techniques in serologic and viral markers of disease, and deployment of highly effective antiretroviral agents, the prognosis of HIV-infected patients has dramatically improved. Over the past two decades, experiences in the management of HIV patients with ESRD is accumulating. Both peritoneal dialysis and hemodialysis are effective modes of therapy and many centers are now beginning to perform renal transplantation in HIV-infected patients. This article deals with various aspects of HIV infection in patients with ESRD.

Human Immunodeficiency Virus Infection in End‐Stage Renal Disease Patients

Precautions used for dialysis patients who have acquired immunodeficiency syndrome or non-A, non-B hepatitis are based on infection control strategies developed for the control of hepatitis B in dialysis centers. Specificially, these recommendations include identifying infected patients; isolating (except for non-A, non-B hepatitis patients) patients, and separating staff, and equipment; applying blood precautions and aseptic techniques; and using good environmental control procedures. AIDS patients can be safely dialyzed by either hemodialysis or peritoneal dialysis in hospital-based or free-standing centers, or at home without risk of AIDS transmission to other patients or to staff members, if precautions that have been developed for the control of hepatitis B infection in dialysis units are employed. Further, the type of dialysis treatment, or modality, should be based on the needs of the patient and not on a fear of risk of disease transmission.

/pdf/recommended-precautions-for-patients-undergoing-hemodialysis-4tstr1lqrx.pdf

Recommended precautions for patients undergoing hemodialysis who have AIDS or non-A, non-B hepatitis.

/pdf/transplantation-for-patients-infected-with-human-5bwcsgu6x7.pdf

Transplantation for Patients Infected with Human Immunodeficiency Virus: No Longer Experimental but Not Yet Routine

https://www.ajkd.org/article/S0272-6386(97)90336-X/pdf

Uremia therapy in patients with end-stage renal disease and human immunodeficiency virus infection: has the outcome changed in the 1990s?

https://www.ajkd.org/article/S0272-6386(88)80174-4/pdf

Renal Complications of Acquired Immunodeficiency Syndrome in Children

Dismal prognosis despite maintenance hemodialysis in AIDS nephropathy and chronic uremia.

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Dismal prognosis despite maintenance hemodialysis in AIDS nephropathy and chronic uremia.