MANAGING MULTIMORBIDITY IN ADVANCED HUMAN IMMUNODEFICIENCY VIRUS INFECTION WITH DIABETIC KIDNEY DISEASE AND PERIPHERAL ARTERIAL DISEASE

Sri Retnowati, Robert Satriyo Budi Susilo, Dhani Redhono Harioputro, Arifin Arifin, Ega Caesaria Pratama Putra, Ratih Tri Kusuma Dewi

Abstract

Advanced human immunodeficiency virus infection is often accompanied by multimorbidity that complicates clinical management and patient outcomes. A 48-year-old man with advanced human immunodeficiency virus infection, uncontrolled type 2 diabetes mellitus, diabetic kidney disease stage 5, peripheral arterial disease, and community-acquired pneumonia was admitted with a two-week history of productive cough and progressive dyspnoea. Laboratory evaluation revealed normochromic anaemia, hypoalbuminemia, and markedly elevated urea and creatinine levels, while chest radiography showed left-sided pulmonary consolidation and cardiomegaly. The patient received renal-adjusted antibiotic therapy, antiretroviral treatment, insulin-based glycaemic control, antihypertensive and antiplatelet therapy, and maintenance haemodialysis. Respiratory symptoms improved during hospitalization and metabolic parameters stabilized. The patient was discharged in stable condition with continued antiretroviral therapy and scheduled haemodialysis. This case highlights the complexity of managing infection, metabolic disturbances, and renal failure in patients with advanced human immunodeficiency virus infection and multiple comorbidities, emphasizing the importance of coordinated multidisciplinary care.

Keywords

Multimorbidity; Human Immunodeficiency Virus Infection; Diabetic Kidney Disease; Peripheral Arterial Disease; Community Acquired Pneumonia

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References

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DOI: https://doi.org/10.20961/tscm.v3i4.116547

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