skip to main content

HIV CKD Renoprotection — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateChronic Kidney DiseaseHIV CKD RenoprotectionESENeph

A 45-year-old man with HIV on antiretroviral therapy (including Tenofovir Alafenamide) develops CKD. His eGFR is 45 mL/min/1.73m2 with uACR 55 mg/mmol. He also has hypertension. He is not on a RASi. What renoprotective medications should be added?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — ACEi or ARB and consider SGLT2i

HIV-associated CKD management follows general CKD principles. RASi (ACEi/ARB) is first-line for proteinuric CKD with hypertension. SGLT2i should also be considered given eGFR 45 and ACR 55 mg/mmol (meeting KDIGO 2024 criteria). Drug interactions between ART and renoprotective agents should be checked. TAF has a better renal safety profile than TDF but does not eliminate CKD progression from other causes (hypertension, HIV itself). Standard CKD care applies in addition to ART optimisation.

Reference: KDIGO 2024 – CKD; BHIVA 2021 – HIV and Kidney Disease