HIV and ID Observations

An ongoing dialogue on HIV/AIDS, infectious diseases,
all matters medical, and some not so medical.

March 28th, 2010

Kidneys: Fortunately, We Have Two

kidneyHere’s a case over in our Journal Watch: AIDS Clinical Care site:  a man with suspected PCP develops rapidly progressive renal failure after being starting on both empiric PCP treatment with TMP-SMX and ART with TDF/FTC plus darunavir/ritonavir.

The specific questions at the end of the case were:

  • What do you think is causing the renal failure?
  • Would you continue empiric treatment for PCP or try to confirm the diagnosis?
  • If you would continue empiric treatment, would you modify it?
  • What would you do with his ART? Specifically, would you continue the tenofovir?
  • What would be your preferred alternative regimen?

I ran into the nephrologist Jonathan Winston this weekend, who will providing his take on the case shortly.  He asked me what actually happened.

Stay tuned …

[Edit:  Outcome of case now posted here.]

Categories: Antiretroviral Rounds, Health Care, HIV, Patient Care
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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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