“HIV infection remains associated with inferior dialysis survival for [nonwhites], even in the contemporary era and with widespread ART use,” Dr. Sawinski and her colleagues summarized. “Although the underlying mechanisms of these racial disparities require further elucidation, bias within the health care system could contribute to worse outcomes for [nonwhite] individuals who have HIV, and dialysis providers should work to eliminate disparities in care wherever they are identified.”
They recommended early nephrology referral for transition to renal replacement therapy and care coordination with infectious disease and hepatology specialists, including evaluation for home dialysis, to improve the chances of survival in these patients. Given the added risk of death in coinfected individuals, they also suggested that therapy for HCV may be beneficial.
One author consulted on a project related to hyperkalemia and hyperphosphatemia in dialysis patients and has grant funding from Merck on treating hepatitis C infection after kidney transplantation. The other authors had no disclosures.