How you and your care provider can keep your kidneys healthy
Do get your kidney function examined early
Anyone with HIV is at risk for kidney disease, which can damage the kidneys and lead to organ failure. “All patients should have their serum creatinine checked and a urinalysis at the time of their HIV diagnosis,” says Dr. Rudy Rodriguez, an associate professor of medicine at the University of Washington in Seattle (see “Kidney Report”). “People at high risk, especially those who are African American and patients with low CD4 counts, and people with other risk factors like diabetes, hypertension or using tenofovir [in Viread, Truvada and Atripla] should be tested yearly thereafter.”
Don’t stretch the truth
Be upfront about any health issues you’re having. Tell your doctor if you’ve been skipping doses or haven’t been following a healthy diet. Otherwise, Rodriguez says, your doctor may overprescribe meds thinking your blood pressure is difficult to control.
Do monitor your blood pressure
Talk to your doctor about how you can improve your diet and get more exercise. In addition, you may need a medication such as an ACE inhibitor to help regulate blood flow. Try to keep your blood pressure below 120/80 if possible. Keep your cholesterol in check, exercise and quit smoking.
Don’t forget kidneys when taking meds
If you have HIV and kidney disease, you may need to avoid certain meds or adjust their doses. Unhealthy kidneys can mean elevated blood levels of certain HIV meds, which can lead to serious side effects. Be sure to check with your doctor. Says Rodriguez: “What may work for one patient may be an improper dose for you.”
Do follow your regimen
HIV itself can damage the kidneys. The condition, called HIV-associated nephropathy (HIVAN), is most common among positive black men. HIV treatment can both prevent and manage the condition. But be aware that some antiretroviral (ARV) meds can cause kidney toxicity, says Dr. Rodriguez.
Don’t delay treatment
If you don’t have insurance, call your local health department to find the nearest public hospital for the uninsured. “Hospitals in cities or towns with Latino populations will have bilingual staff,” says Dr. Rodriguez. Some hospitals can even set up a teleconference with an on-call interpreter if one isn’t immediately available.
Do think positive—¡sí se puede!
You cannot be denied access to medical care because of your immigration status or if you are an undocumented immigrant. It’s your health that’s at risk, so talk to your doctor when you’re not sure about anything having to do with your medical status.