Evidence for an HIV-related nephropathy: a clinico-pathological study.
The existence of an HIV-related nephropathy as a distinct disease entity is controversial. We observed a high incidence of renal disease in our AIDS patients. Of 182 patients, 59 patients (32.4%) were found to have heavy proteinuria (greater than 2 g/24 h). Of these, 24 patients had slow progression of renal insufficiency and 2 patients had rapid deterioration to end stage renal disease. There was a notable absence of hypertension in these cases. The incidence of proteinuria was similar in blacks and hispanics; however 22.8% of blacks had renal insufficiency as compared to 6.9% of hispanics. There was no difference in the incidence of heavy proteinuria between intravenous drug abusers (32.3%) and nonabusers (33.3%). Renal morphology when examined showed characteristic changes, including cytomembranous structures and virus-like particles. These changes were similar in patients with heavy or light proteinuria, though they were less severe in the latter. We conclude that a HIV-related nephropathy exist and the presence of cytomembranous structures and virus-like particles in the renal tissue raises the possibility of a viral etiology for this disorder.
Soni
A
A
Department of Internal Medicine, New York Medical College, Lincoln Medical Center, Bronx 10451.
Agarwal
A
A
Chander
P
P
Yoo
J
J
Singal
D
D
Salomon
N
N
Robinson
B
B
Treser
G
G
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D005260:Female; D006556:Heroin Dependence / Q000150:complications; D006630:Hispanic or Latino; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications; D007683:Kidney Tubular Necrosis, Acute / Q000150:complications; D008297:Male; D009519:New York City; D011507:Proteinuria / Q000150:complications; D044469:Racial Groups