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HIV Nephropathy
Aka: HIV Nephropathy, AIDS associated Nephropathy
- See Also
- Nephropathy
- Renal Manifestations of HIV
- HIV Complications
- Epidemiology
- HIV Nephropathy is associated with increased mortality in HIV
- Risk Factors
- Black race
- Older age
- Advanced Immunosuppression
- CD4 Count <200 cells/mm3
- HIV Viral Loads high
- Hepatitis CVirus coninfection
- Injection drug use
- Signs
- Proteinuria
- Nephrotic Syndrome
- Azotemia (Rapidly progressive, irreversible)
- Course
- End Stage Renal Disease develops in 4-16 weeks
- Differential Diagnosis:
- Heroin-associated nephropathy
- HIV Nephropathy lacks:
- Severe Hypertension
- Peripheral Edema
- Anasarca
- Diagnosis
- Renal Ultrasound
- Kidneys are usually enlarged in HIV Nephropathy
- Renal Biopsy confirms diagnosis
- Management
- No known treatment
- Antiretroviral therapy for HIV
- ACE Inhibitor or Angiotensin Receptor Blocker
- See ACE Inhibitors and ARBs in Diabetic Nephropathy
- Indicated for persistent Proteinuria
- Prevention
- Screen for renal disease at time of HIV diagnosis and then every 6 months (more frequently if high risk)
- Avoid Nephrotoxic Drugs
- See Renal Manifestations of HIV
- See Nephrotoxic Drugs
- References
- Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]