Acute renal failure in HIV-infected patients: a brief review of common causes.
Acute renal failure is a well-described renal syndrome observed in patients infected with the human immunodeficiency virus (HIV). Underlying glomerular disease and disturbances in renal tubular function predispose these patients to a number of hemodynamic and nephrotoxic insults. Prerenal azotemia from both "true" and "effective" depletion of intravascular volume is the most common cause of acute renal insufficiency in patients infected with HIV. Direct damage to the renal tubules from both nephrotoxic medications and prolonged ischemic processes occurs frequently in hospitalized patients. Injury to the tubulointerstitium of the kidney may also result from allergic reactions to medications prescribed to patients. Deposition of crystals in the tubular lumens, and rarely in the glomerular capillaries, will cause acute renal failure in the setting of tumor lysis syndrome or during therapy with medications associated with crystal nephropathy. Finally, obstruction of the urinary system will rarely cause postrenal azotemia in patients infected with HIV.
Perazella
M A
MA
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06520, USA. mark.perazella@yale.edu
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D019380:Anti-HIV Agents / Q000009:adverse effects; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007669:Kidney Calculi / Q000150:complications; D007684:Kidney Tubules / Q000473:pathology; D009336:Necrosis; D009395:Nephritis, Interstitial / Q000150:complications; D014511:Uremia / Q000150:complications; D014517:Ureteral Obstruction / Q000150:complications
D019380:Anti-HIV Agents