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The spectrum of kidney disease in patients with AIDS in the era of antiretroviral therapy
- Source :
- Kidney International. 75(4):428-434
- Publication Year :
- 2009
- Publisher :
- Elsevier BV, 2009.
-
Abstract
- With prolonged survival and aging of the HIV-infected population in the era of antiretroviral therapy, biopsy series have found a broad spectrum of HIV-related and co-morbid kidney disease in these patients. Our study describes the variety of renal pathology found in a prospective cohort of antiretroviral-experienced patients (the Manhattan HIV Brain Bank) who had consented to postmortem organ donation. Nearly one-third of 89 kidney tissue donors had chronic kidney disease, and evidence of some renal pathology was found in 75. The most common diagnoses were arterionephrosclerosis, HIV-associated nephropathy and glomerulonephritis. Other diagnoses included pyelonephritis, interstitial nephritis, diabetic nephropathy, fungal infection and amyloidosis. Excluding 2 instances of acute tubular necrosis, slightly over one-third of the cases would have been predicted using current diagnostic criteria for chronic kidney disease. Based on semi-quantitative analysis of stored specimens, pre-mortem microalbuminuria testing could have identified an additional 12 cases. Future studies are needed to evaluate the cost-effectiveness of more sensitive methods for defining chronic kidney disease, in order to identify HIV-infected patients with early kidney disease who may benefit from antiretroviral therapy and other interventions known to delay disease progression and prevent complications.
- Subjects :
- Nephrology
Adult
Male
Pathology
medicine.medical_specialty
Anti-HIV Agents
Interstitial nephritis
kidney disease
030232 urology & nephrology
Article
Nephropathy
Diabetic nephropathy
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Glomerulonephritis
Internal medicine
medicine
Humans
030212 general & internal medicine
Organ donation
AIDS-Associated Nephropathy
Prospective Studies
Acquired Immunodeficiency Syndrome
Nephrosclerosis
business.industry
Middle Aged
medicine.disease
Tissue Donors
3. Good health
AIDS
HIV-associated nephropathy
histopathology
Female
Kidney Diseases
business
Kidney disease
Subjects
Details
- ISSN :
- 00852538
- Volume :
- 75
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Kidney International
- Accession number :
- edsair.doi.dedup.....e47be5ca129e4626b9c9808ac67adbd0
- Full Text :
- https://doi.org/10.1038/ki.2008.604