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. 2009 Nov;11(6):479-85.
doi: 10.1007/s11908-009-0069-4.

HIV and the Kidney

Leslie A Bruggeman  1 , Charles Bark, Robert C Kalayjian
Affiliations

HIV and the Kidney

Leslie A Bruggeman et al. Curr Infect Dis Rep. 2009 Nov.

Abstract

Direct effects of HIV-1 infection on the kidney combine with immune and genetic factors, comorbidities, coinfections, and medication toxicities to induce a spectrum of kidney disorders in HIV disease. The most dramatic of these, HIV-associated nephropathy (HIVAN), emerges almost exclusively in persons of African descent and is associated with rapid progression to end-stage renal disease in the absence of antiretroviral therapy (ART). ART modifies the natural history of HIVAN, but the renal benefits of ART may not be limited to HIVAN. ART is often under prescribed or incorrectly dosed in persons with kidney disease. Vigilant attention to renal function and an understanding of the complex associations involving the kidneys are necessary for optimal care of these patients.

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Figures

Figure 1
Figure 1. Histopathology of HIVAN
A. Collapsed glomerulus with greatly enlarged urinary space with evidence of proteinaceous and cellular debris in primary filtrate. B. Tubulointerstitial compartment with tubular atrophy and microcystic tubules, many of which are filled with proteinaceous casts. Interstitial changes also include fibrosis and immune cell infiltrates.
See this image and copyright information in PMC

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