Diagnosis and treatment of HIV-associated nephropathy.
Human immunodeficiency virus-associated nephropathy (HIVAN) is a distinct clinico-pathological syndrome that occurs almost exclusively in black patients with an AIDS defining diagnosis. It is characterized by rapidly progressive renal failure with a severe nephrotic syndrome. The renal biopsy typically shows a collapsing glomerular sclerosis and variable tubulo-interstitial nephritis. The pathogenesis most likely involves infection of renal tubular and epithelial cells with HIV. The use of ACE-inhibitors and steroids may slow down the progression to end-stage renal failure. With the introduction of highly active anti-retroviral therapy, HIVAN may now be treated effectively although clinical data are so far limited to case-reports.
Betjes
M G
MG
Department of Internal Medicine, Division of Nephrology and Hypertension, University Hospital Rotterdam-AZR, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Weening
J
J
Krediet
R T
RT
D016263:AIDS-Associated Nephropathy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D044383:Black People; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D007676:Kidney Failure, Chronic / Q000821:virology; D008297:Male; D009404:Nephrotic Syndrome / Q000821:virology; D013256:Steroids; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000893:Anti-Inflammatory Agents; D013256:Steroids; D003404:Creatinine