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Antiretrovirals and the kidney in current clinical practice: renal pharmacokinetics, alterations of renal function and renal toxicity

Yombi, Jean C.a,b; Pozniak, Antonb; Boffito, Martab; Jones, Rachaelb; Khoo, Sayec; Levy, Jeremyd; Post, Frank A.e

doi: 10.1097/QAD.0000000000000103
Editorial Reviews

Assessment of renal function in HIV-positive patients is of increasing importance in the context of ageing and associated comorbidities. Exposure to nephrotoxic medications is widespread, and several commonly used antiretroviral drugs have nephrotoxic potential. Moreover, specific antiretrovirals inhibit renal tubular transporters resulting in the potential for drug–drug interactions as well as increases in serum creatinine concentrations, which affect estimates of glomerular filtration rate in the absence of changes in actual glomerular filtration rate. This review explores the effects of antiretroviral therapy on the kidney and offers an understanding of mechanisms that lead to apparent and real changes in renal function.

aAIDS Reference Centre, St Luc University Hospital, Catholic University of Louvain, Brussels, Belgium

bSt Stephen's AIDS Trust, Chelsea and Westminster Hospital, London

cUniversity of Liverpool, Liverpool

dImperial College Healthcare NHS Trust

eKing's College London School of Medicine, London, UK.

Correspondence to Dr Frank A. Post, King's College London, Weston Education Centre (Rm 2.53), Cutcombe Road, London SE5 9RS, UK. Tel: +44 2078485779; fax: +44 2078495769; e-mail:

Received 11 September, 2013

Revised 1 October, 2013

Accepted 1 October, 2013

© 2014 Lippincott Williams & Wilkins, Inc.