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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jan 6, 2016; 5(1): 33-42
Published online Jan 6, 2016. doi: 10.5527/wjn.v5.i1.33
Water, electrolytes, and acid-base alterations in human immunodeficiency virus infected patients
Carlos G Musso, Waldo H Belloso, Richard J Glassock
Carlos G Musso, Division of Nephrology, Department of Medicine, Hospital Italiano de Buenos Aires, Buenos Aires C1199ABB, Argentina
Waldo H Belloso, Infectology Section, Division of Internal Medicine, Department of Medine, Hospital Italiano de Buenos Aires, Buenos Aires C1199ABB, Argentina
Richard J Glassock, Department of Medicine, Geffen School of Medicine, UCLA, Los Angeles, CA 90095, United States
Author contributions: Musso CG and Belloso WH collected the data and wrote the paper; Glassock RJ reviewed and edited the paper.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlos G Musso, MD, PhD, Division of Nephrology, Department of Medicine, Hospital Italiano de Buenos Aires, Gascón 450, Buenos Aires C1199ABB, Argentina. carlos.musso@hospitalitaliano.org.ar
Telephone: +54-9-1149590200-8724 Fax: +54-9-1149590200-8664
Received: June 3, 2015
Peer-review started: June 7, 2015
First decision: August 16, 2015
Revised: September 5, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: January 6, 2016
Abstract

The clinical spectrum of human immunodeficiency virus (HIV) infection associated disease has changed significantly over the past decade, mainly due to the wide availability and improvement of combination antiretroviral therapy regiments. Serious complications associated with profound immunodeficiency are nowadays fortunately rare in patients with adequate access to care and treatment. However, HIV infected patients, and particularly those with acquired immune deficiency syndrome, are predisposed to a host of different water, electrolyte, and acid-base disorders (sometimes with opposite characteristics), since they have a modified renal physiology (reduced free water clearance, and relatively increased fractional excretion of calcium and magnesium) and they are also exposed to infectious, inflammatory, endocrinological, oncological variables which promote clinical conditions (such as fever, tachypnea, vomiting, diarrhea, polyuria, and delirium), and may require a variety of medical interventions (antiviral medication, antibiotics, antineoplastic agents), whose combination predispose them to undermine their homeostatic capability. As many of these disturbances may remain clinically silent until reaching an advanced condition, high awareness is advisable, particularly in patients with late diagnosis, concomitant inflammatory conditions and opportunistic diseases. These disorders contribute to both morbidity and mortality in HIV infected patients.

Keywords: Human immunodeficiency virus, Acquired immune deficiency syndrome, Salt, Water, Potassium, Acid-base

Core tip: Human immunodeficiency virus infected patients, and particularly those with acquired immune deficiency syndrome, are predisposed to different water, electrolyte, and acid-base disorders since they have a modified renal physiology and they also are exposed to infectious, inflammatory, endocrinological, oncological, and pharmacological variables whose combination undermine their homeostatic capability. We herein discuss each of these internal milieu alterations usually observed in this group.