HIV-associated nephropathy: clinical characteristics and therapeutic options.
HIV-associated nephropathy is a unique form of renal disease specific to HIV infection. Proteinuria and rapidly worsening azotemia in the absence of edema and hypertension are characteristic. Renal biopsy reveals collapsing and/or sclerotic glomeruli, microcystic tubular dilatation, and cellular interstitial infiltrates. Direct cytopathic effects of HIV in the setting of a particular cytokine milieu appears to be the mechanism responsible for the renal injury. There is limited therapeutic experience, but trials with steroids and angiotensin-converting enzyme inhibitors are encouraging. Dialysis is the main form of renal replacement therapy. Better understanding of the disease should improve treatment and prognosis.
Rogosin Institute, Department of Nephrology, New York Presbyterian Hospital-Cornell University Medical College, New York, NY, USA.
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RM
Bologna
D016263:AIDS-Associated Nephropathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006435:Renal Dialysis