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But " subclinical " cell changes may go unnoticed for long periods of time , and certain HPV types ( 16 , 18 , 31 , 33 , and 35 ) are now known to be associated with an increased risk of cancerous or pre-cancerous cell changes on the cervix and in the rectum . Examples of patients at risk for renal failure include patients older than 65 years ; patients who use nephrotoxic drugs ; and patients with preexisting renal insufficiency , diabetes mellitus , volume depletion , sepsis , or paraproteinemia . The US Food and Drug Administration ( FDA ) recommends that , for patients at risk for renal failure , the recommended doses should not be exceeded and the infusion rates and concentrations should be the minimum levels that are practicable . Before prescribing medication to suppress or modify cough , it is important to ascertain that the underlying cause of cough is identified , that modification of cough does not increase the risk of clinical or physiological complications , and that appropriate therapy for the primary disease is provided . Use of high assurance development methods is RECOMMENDED for implementations of this specification , in order to reduce the risk of subtle implementation flaws that might adversely impact the operational risk reduction that this specification seeks to provide . Patients who undergo splenectomy because of thalassemia or Hodgkin disease have a higher risk of overwhelming infection than those patients with functional hyposplenia secondary to sickle cell disease . The US Food and Drug Administration ( FDA ) advises that , in patients at risk for renal failure , the recommended doses should not be exceeded and that infusion rates and concentrations should be at the practicable minimum levels . Overall , the severity of fat loss and the risk of clinical lipoatrophy is approximately halved with zidovudine treatment compared to stavudine . The US Food and Drug Administration ( FDA ) recommends that for patients at risk for renal failure ( eg , preexisting renal insufficiency , diabetes , volume depletion , sepsis , paraproteinemia , age > 65 y , use of nephrotoxic drugs ) , recommended doses should not be exceeded and infusion rates and concentrations should be the minimum levels that are practicable .