Ding Y, et al. - Given an increase in clinical uncertainty about changes in renal function in correlation to the use of combination antiretroviral therapy (cART), researchers investigated how aging, baseline renal impairment, and stages of HIV infection influence post-treatment changes in renal function. Analysis of 5533 HIV-infected patients on cART was done. Multivariable analysis revealed a significant positive baseline-estimated glomerular filtration rate (eGFR)-by-World Health Organization (WHO)-stage interaction effect on progression to chronic kidney disease (CKD) in all patients. this suggests a cross-over effect from a reduced risk to an increased risk. Patients with baseline normal renal function showed a significant negative baseline-age-by-WHO-stage interaction effect on progression to mild renal impairment, with adjusted hazard ratios progressively lower at older ages. Further, they noted significant correlations with older age, lower baseline eGFR, Dai ethnic minority, and anaemia for both outcomes, hyperglycaemia for CKD only, and higher CD4 count, tenofovir and ritonavir-boosted lopinavir use for mild renal impairment only. As per these findings, patients on cART show a complex pattern of renal function dynamics, which requires careful management with systematic monitoring of the interaction of the effects of sociodemographic, nephrological and HIV-specific clinical characteristics.