title: Zidovudine is beneficial in human immunodeficiency virus associated nephropathy.
abstract: Human immunodeficiency virus associated nephropathy (Hivan) is a distinct renal disease described in patients infected with the human immunodeficiency virus (HIV). Hivan is characterized by a nephrotic syndrome, enlarged kidneys, a histologic finding of focal and segmental glomerulosclerosis, and a very rapid progression to end-stage renal disease (ESRD). No therapeutic intervention has been shown, in a prospective evaluation, to either alter the course of established Hivan or to influence the emergence of Hivan in HIV-infected patients. We conducted a prospective study on 23 consecutively selected patients seen between 1989 and 1992 who were infected with the HIV, 14 (61%) of whom had significant proteinuria (> or = 2+). Percutaneous kidney biopsy was performed in 5 (36%) of the 14 subjects who had significant proteinuria, and histologic examination of the kidney tissue revealed focal and segmental glomerulosclerosis in all 5 cases. Of the 14 subjects with proteinuria, 8 (57%) also had azotemia (serum creatinine level > or = 1.3 mg/dl). Nine (39%) of 23 subjects admitted intravenous drug use, while 9 (39%) of 23 subjects have had an opportunistic infection before enrollment in the study. The known duration of HIV infection before initiation of zidovudine therapy was 10.3 +/- (SD) 8 months. The mean CD4 count before zidovudine therapy was 195.9 +/- 117 (range 21-654) cells/mm3. The mean dose of zidovudine administered was 543 +/- 117 (range 400-800) mg daily for a period of 20.4 +/- 11 (range 6-38) months.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: State University of New York Health Science Center, Department of Medicine, Brooklyn 11203, USA.
authors.forename: O
authors.initials: O
authors.lastname: Ifudu
authors.forename: T K
authors.initials: TK
authors.lastname: Rao
authors.forename: C C
authors.initials: CC
authors.lastname: Tan
authors.forename: H
authors.initials: H
authors.lastname: Fleischman
authors.forename: K
authors.initials: K
authors.lastname: Chirgwin
authors.forename: E A
authors.initials: EA
authors.lastname: Friedman
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D011446:Prospective Studies; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D015215:Zidovudine