An ongoing dialogue on HIV/AIDS, infectious diseases,
March 28th, 2010
Kidneys: Fortunately, We Have Two
Here’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.]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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