Renal Manifestations of HIV

Aka: Renal Manifestations of HIV, HIV Related Renal Complications, HIV-Relared Kidney Disease, Kidney Disease Associated with AIDS

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II. Causes: Glomerular Disease

  1. See Glomerulonephritis
  2. See Glomerulonephritis Causes
  3. HIV Nephropathy (AIDS associated Nephropathy, HIVAN)
  4. HIV Associated Immune Complex Kidney Disease (HIVICK)
  5. Membranoproliferative Glomerulonephritis
  6. Membranous Nephropathy
  7. Thrombotic Microangiopathy

III. Causes: Renal Tubular Disease

  1. Acute Kidney Injury
  2. Fanconi's Syndrome (Proximal Tubule Injury)
  3. Diabetes Insipidus
  4. Crystal Nephropathy
  5. Drug induced Renal toxicity
    1. See Nephrotoxic Drug
    2. Amphotericin B
    3. Foscarnet
    4. Pentamidine
    5. Trimethoprim Sulfamethoxazole
    6. NSAIDs
    7. Tenofovir disoproxil Fumarate (TDF)
      1. Causes proximal tubule dysfunction (e.g. Hypophosphatemia) and decreased Renal Function
      2. Avoid if GFR <60 ml/min and discontinue if GFR falls more than 25% or <60 ml/min
      3. May safely use Tenofovir Alafenamide as alternative (less nephrotoxic)

IV. Causes: Other HIV Related Renal Disorders

  1. Interstitial Nephritis
  2. Fluid and Electrolyte abnormalities
    1. SIADH and Hyponatremia common due to occult infection

V. References

  1. Baloor (2018) Exam Preparatory Manual for Undergraduates Medicine, Jaypee Brothers, India, p. 240
  2. Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]

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