Monitoring kidney function

While taking antiretroviral therapy, regular kidney function monitoring is the best way to prevent kidney problems. At minimum, monitoring should include urinalysis and measurement of serum creatinine and phosphate. Many experts prefer more additional measures, such as creatinine clearance and glomerular filtration rate.

Kidney function screening should be performed before starting antiretroviral therapy; the Infectious Diseases Society of America (IDSA) recommends that this be done at the time of HIV diagnosis.1 Ongoing monitoring should then be performed regularly during treatment with potentially toxic drugs.

The IDSA recommends periodic kidney function monitoring during the first six months, then twice annually for patients taking indinavir. The European Medicines Agency (EMEA) guidelines advise that patients receiving tenofovir should be monitored every four weeks for the first year and thereafter, every three months. Patients who have pre-existing kidney impairment, are taking other potentially nephrotoxic drugs, or are otherwise at increased risk should receive more frequent monitoring, as often as every few weeks.

It is important that kidney function monitoring continue throughout the course of treatment. Whilst drug-related kidney toxicity typically emerges during the first six to twelve months, later emergence of kidney stones and tenofovir-induced nephrotoxicity has been reported.2 More frequent kidney function monitoring is recommended for children.


  1. Gupta SK et al. Guidelines for the management of chronic kidney disease in HIV-infected patients: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 40: 1559-1585, 2005
  2. Thanh DC et al. Lopinavir-ritonavir (Kaletra) and lithiasis: seven cases. AIDS 18: 705-706, 2004
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.