[Nephropathy in human immunodeficiency virus infection]

Abstract

Background: Patients with the human immunodeficiency virus (HIV) infection may present different types of nephropathy with focal segmentary glomerulosclerosis (FSGS) being the most specific lesion associated to HIV (HIVN). The prevalence of this entity varies between 1 to 23%. These differences have been attributed to ethnic factors and/or intravenous drug addiction (IVDA). The renal alterations presented in these patients with HIV infection were analyzed.

Methods: Two groups of patients were studied: Group I with 300 consecutive patients with advanced HIV infection (complex related with AIDS) treated with zidovudine without initial kidney infection followed for a mean of 19 +/- 11 months (99% caucasian, 65% IVDA, 66% AIDS); and group II with 11 patients with HIV infection remitted for kidney involvement (4 on hemodialysis).

Results: Group I: 26 cases (9%) presented acute reversible kidney failure (12 prerenal, 9 nephrotoxicity and 5 mixed). No patient presented HIVN criteria. Group II: one black patient developed HIVN and had no known risk factors. The remaining patients presented glomerular changes different from those of HIVN.

Conclusions: The scarce prevalence of human immunodeficiency virus nephropathy in the present series is of note despite the high number of intravenous drug addicts included suggesting that ethnic factors determine the differences observed in different series. The most frequent kidney disturbances seen are those related with infectious complications associated to the acquired immunodeficiency syndrome and the treatment of the same.