> Let's Forward this Post Everywhere ❕ *A Lifeline for Zimbabweans living with HIV* ‼️ *....ARVs pills causing kidney damage* https://whatsapp.com/channel/0029VaDkMuTFCCoNC13vvo2V _*©Eragon Online News*_ *_(Follow this channel to read more...)_* *Group Link:* https://chat.whatsapp.com/CDyzvhE1ey5H89lorhyIvn People living with HIV face a Catch 22 situation when antiretroviral therapy (ART) potentially causes kidney damage. Staying on ART is crucial to suppress the virus, but it may worsen kidney health. Stopping ART isn’t a viable option due to the risk of uncontrolled HIV replication. Healthcare providers work closely with patients to balance treatment benefits and risks, adjusting plans to minimise side effects while maintaining viral suppression. This complex management requires careful monitoring to ensure optimal health outcomes. For many people living with HIV, renal failure has become an expected outcome that one will die. With limited renal services in the country’s public health facilities, only 700 patients with renal failure can access the life-saving dialysis treatment monthly out of more than a thousand in need of the lifeline. In a long-awaited gesture, the National AIDS Council (NAC) has partnered Parirenyatwa Group of Hospitals’ renal unit in providing essential dialysis services to people living with HIV (PLHIV). The initiative is open to other patients in need of renal care. The programme provides funding for essential dialysis services, including reagents and consumables, at Parirenyatwa Hospital’s Renal unit. In a telephone interview with the NAC Chief Executive Officer, Dr Bernard Madzima after the launch, he said this was important to keep the recipients of care with kidney disease healthy. “This isn’t just about machines and reagents, it is about dignity, about quality of life, and ensuring that the people we have fought so hard to keep alive through ART don’t die because of something we can treat,” said Dr Bernard Madzima. Importance of Renal Services for PLHIV With Kidney Disease Some people Living with HIV (PLHIV) on lifelong Antiretroviral Therapy (ART) require renal services due to increased kidney disease risk. When one has kidney damage from anti HIV treatment, this can result in damage to kidney cells, leading to HIV-associated nephropathy (HIVAN). *ART-Related Kidney Toxicity:* Certain ART medications, like Tenofovir disoproxil fumarate (TDF), can cause kidney toxicity. Comorbidities: PLHIV are more likely to develop hypertension, diabetes, and cardiovascular disease, increasing kidney disease risk. Increased Risk of Kidney Failure PLHIV are more susceptible to kidney failure, requiring dialysis or transplantation. *Side Effects of ART*: While ART manages HIV, some medications have side effects, including: Kidney Toxicity: TDF can cause kidney damage or exacerbate existing problems. Bone Density Loss: TDF can lead to bone density loss, increasing osteoporosis and fracture risk. Lipodystrophy: Some ART medications can cause changes in body fat distribution. Gastrointestinal Issues: Nausea, vomiting, diarrhea, or abdominal pain can occur. Hepatic Toxicity: Certain ART medications can cause liver damage or elevate liver enzymes. Metabolic Changes: ART can lead to changes in lipid profiles, glucose metabolism, or insulin resistance. *Mitigating Risks*: Regular monitoring and management of kidney health, along with careful ART regimen selection, can help mitigate these risks and ensure optimal health outcomes for PLHIV. By prioritizing renal services and addressing ART-related side effects, healthcare providers can improve the overall well-being of individuals living with HIV. (Source: Frontiers website, according to the National Institutes of Health [NIH]) “The NAC’s initiative is expected to benefit hundreds of patients annually, with priority given to the most vulnerable,” said Dr Madzima. With additional support and donor alignment, the model could be expanded to other provincial hospitals. “As NAC, we felt the need to step in and assist after Parirenyatwa Hospital reached out to us asking for assistance, ” Dr Madzima explained. “Their requirement is around US$700,000 per year… Dialysis services are critical, and it’s a timely intervention that improves the quality of life for those in need,” said Dr Madzima. The Zimbabwe Non Communicable Diseases Champions Network, led by Advocate Jacob Ngwenya, commended the National AIDS Council’s initiative to prioritise kidney care for people living with HIV. “We need a full continuum of care for renal disease, encompassing health promotion, prevention, treatment, care, support, rehabilitation, and palliative care,” said Advocate Jacob Ngwenya. The NCD network urges the government to decentralise this model to all provinces, ensuring health equity and comprehensive healthcare that addresses the unique needs of individuals living with HIV and comorbidities. “By working together, Zimbabwe can create a healthcare system that is equitable, accessible, and responsive to the needs of all citizens,” said Advocate Ngwenya in a statement to all media houses. The growing burden of renal disease is silently gathering pace. This comes amid growing concern about the hidden epidemic of kidney failure among people on lifelong antiretroviral therapy (ART). While ART has significantly extended lives, long-term use is now linked with a sharp rise in chronic kidney disease. PLHIV are up to four times more likely to develop chronic kidney disease (CKD) than the general population. Dr Nicholas Mpinga, a nephrologist (kidney disease doctor) said the causes of kidney disease in HIV are multi-factorial. “The causes of CKD are interrelated, including HIV-associated nephropathy (HIVAN), antiretroviral therapy toxicity, comorbidities like hypertension and diabetes, and genetic predisposition. Kidney disease can lead to increased risk of end-stage renal disease (ESRD), cardiovascular disease, and reduced quality of life,” said Dr Mpinga. He stressed comprehensive treatment, care and support for every recipient of life long treatment. “Early detection and monitoring, ART optimisation, comorbidity management, and kidney replacement therapy are essential for managing kidney disease in HIV. Integrated care, multi disciplinary teams, and patient education are crucial for delivering comprehensive and effective care. HIV care should be integrated with kidney disease management. Healthcare teams should include nephrologists, HIV specialists, and other professionals. Patient education is vital for improving outcomes,” stressed the doctor. By understanding the complex relationship between HIV and kidney disease, healthcare providers can deliver optimal care, improving outcomes and quality of life for individuals living with HIV and kidney disease. By integrating services, healthcare providers can better manage chronic conditions, reduce hospitalisations and improve patient outcomes. In an integrated healthcare model, patients benefit from seamless communication and collaboration among healthcare providers. This leads to more accurate diagnoses, effective treatment plans, and enhanced patient satisfaction. “Integrated care also promotes preventive care, early intervention, and better management of comorbidities. By prioritising patient-centered care, integrated healthcare models can improve health outcomes, reduce healthcare costs, and enhance the overall quality of life for individuals with complex health needs,” said Dr Mpinga. Zimbabwe’s move aligns the country with progressive global health strategies, recognising that HIV care must be integrated with broader chronic care. The NAC’s initiative shows a willingness to treat HIV not as a silo condition, but as part of a comprehensive approach to healthcare. As the country navigates the complexities of HIV and comorbidities, the NAC’s kidney care programme offers a beacon of hope for those living with HIV and kidney disease. With continued support and expansion, this initiative has the potential to revolutionise healthcare outcomes for individuals and communities across Zimbabwe. Feedback: [email protected] (For more reading on the topic https://www.facebook.com/share/p/1CfvPhPRND/