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Because nearly one third of HIV patients have abnormal protein levels in their urine--an early warning sign of kidney disease--the HIV Medicine Association has released new guidelines calling for all HIV-positive people to be screened for kidney complications. If possible, screening should begin immediately after HIV diagnosis. 'We're trying to shift gears from how you treat the HIV-infected patient with severe kidney disease to how do we look for the ones who are at risk of developing severe kidney disease and taking care of them early so they don't have to end up going on dialysis,' says Samir Gupta, MD, the guidelines' author. Published in the June 1 edition of the journal Clinical Infectious Diseases, the guidelines say all HIV patients should be given proteinuria and kidney function tests. Patients at highest risk for kidney problems include those of African descent, those with low CD4-cell counts or high HIV viral levels, and HIV patients with diabetes, hypertension, or hepatitis C coinfection.
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