Renal
HIV Nephropathy
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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 Load
s high
Hepatitis C
Virus
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
Kidney
s 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 Drug
s
See
Renal Manifestations of HIV
See
Nephrotoxic Drug
s
References
Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]
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