A new study in the journal AIDS finds that many HIV-positive patients continue to lose kidney function despite successful antiretroviral treatment.

HIV can often lead to kidney failure when kidney cells become infected with HIV. This condition is called HIV-Associated Nephropathy.

Oftentimes, kidney problems can be detected when individuals experience swelling in the face or legs, or if they find changes in urination. Nearly a third of HIV-positive individuals maintain high levels of protein in the urine, which can indicate possible kidney problems.

In this study, 615 patients were followed for an average of 3.4 years in order to examine risk factors associated with the decline of kidney function in HIV-positive patients.

The researchers measured estimated glomerular filtration rate, eGFR, which measures how well the kidneys filter waste from the blood. This allowed them to chart changes in kidney function.

Scientists found that the primary predictors of eGFR decline, or decreased kidney function, included female sex, diabetes, and hyperlipidemia (an increase in the concentration of lipids, or fats, in the blood, including cholesterol and triglycerides).

CD4 cell count and viral load were not associated with eGFR decline.

Surprisingly, individuals who started antiretroviral treatment still showed a decline in kidney function, although at a slower rate. In the group receiving suppressive antiretroviral therapy with viral loads under 500 copies/ml, sudden spikes in viral load were associated with more rapid rates of kidney function loss.

Overall, the researchers found that although antiretroviral therapy can help slow the decline, patients who sustain viral suppression still show loss of kidney function over time.

Usually, a simple urine test can evaluate kidney function by examining the levels of proteins, sugars, and ketones among other vital substances in urine.

Risk factors for kidney disease include high HIV viral loads, low CD4 cell counts, hepatitis B or C, high blood pressure, diabetes, or being of African-American race.

To prevent the occurrence of kidney problems, HIV-infected patients should monitor their blood sugar levels, maintain a healthy blood pressure, and consult with a physician in response to any concerns over possible kidney troubles.

For more information, please see the study in the journal AIDS (abstract).