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HIV infection itself is a risk factor for kidney disease in the older HIV-infected patient compared to matched HIV-uninfected patients. The HIV-infected group was twice as likely to have a decline in renal function and 6 times as likely to have proteinuria. Interestingly, another strong predictor of worsening kidney disease was not having ART modified at the onset of renal dysfunction. This finding illustrates how important it is for clinicians to carefully monitor kidney function in virologically stable older patients, and to consider modifying ART with changes in renal markers.
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