Human immunodeficiency virus nephropathy

Jose Strauss, Gaston E Zilleruelo, Carolyn Abitbol, Brenda Montane, Victoriano Pardo

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Varying components of the syndrome of human immunodeficiency virus nephropathy (HIVN) have been described, the most pertinent including proteinuria/nephrotic syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic kidneys, rapid progression to end-stage renal disease (ESRD), and no response to treatment regimens. The diagnosis of HIVN requires identification of excessive proteinuria or albuminuria, determined by a total protein excretion on a timed urine collection or a high protein/creatinine ratio in a random specimen. Various pathological lesions have been found in HIVN. The lesion of focal and segmental sclerosis (FS/FSS) is most characteristic in adults and usually is associated with a rapid demise. FS/FSS also has been described in approximately one-half of the pediatric patients reported in the literature (31/64). Despite progression to ESRD, the clinical course in children with HIVN is less fulminant than in adults. Other reported histological findings include primarily mesangial hyperplasia as well as minimal change, focal necrotizing glomerulonephritis or lupus nephritis, and hemolytic uremic syndrome. In addition to glomerular pathology, interstitial findings of dilated tubules filled with a unique proteinaceous material, atrophied tubular epithelium, and interstitial cell infiltration are very common. On electron microscopy, most investigators have found tubuloreticular inclusion bodies in endothelial cells of glomerular capillaries. Treatment of patients who develop ESRD remains highly controversial. Most adult patients treated with hemodialysis have succumbed rapidly; peritoneal dialysis has been better tolerated. Transplantation in patients with HIV infection must be considered to be tentative, with reports of acceleration towards full blown acquired immunodeficiency syndrome in some and uneventful 5-year survival in others. The situation of the pediatric patient with HIVN remains unclear and awaits the benefit of experience.

Original languageEnglish
Pages (from-to)220-225
Number of pages6
JournalPediatric Nephrology
Volume7
Issue number2
DOIs
StatePublished - Apr 1 1993

Fingerprint

HIV
Chronic Kidney Failure
Proteinuria
Pediatrics
Azotemia
Urine Specimen Collection
Hemolytic-Uremic Syndrome
Lupus Nephritis
Albuminuria
Inclusion Bodies
Nephrotic Syndrome
Sclerosis
Peritoneal Dialysis
Glomerulonephritis
HIV Infections
Hyperplasia
Renal Dialysis
Creatinine
Electron Microscopy
Acquired Immunodeficiency Syndrome

Keywords

  • Acquired immunodeficiency syndrome
  • Focal glomerulosclerosis
  • Human immunodeficiency virus
  • Nephropathy
  • Proteinuria

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Strauss, J., Zilleruelo, G. E., Abitbol, C., Montane, B., & Pardo, V. (1993). Human immunodeficiency virus nephropathy. Pediatric Nephrology, 7(2), 220-225. https://doi.org/10.1007/BF00864411

Human immunodeficiency virus nephropathy. / Strauss, Jose; Zilleruelo, Gaston E; Abitbol, Carolyn; Montane, Brenda; Pardo, Victoriano.

In: Pediatric Nephrology, Vol. 7, No. 2, 01.04.1993, p. 220-225.

Research output: Contribution to journalArticle

Strauss, J, Zilleruelo, GE, Abitbol, C, Montane, B & Pardo, V 1993, 'Human immunodeficiency virus nephropathy', Pediatric Nephrology, vol. 7, no. 2, pp. 220-225. https://doi.org/10.1007/BF00864411
Strauss J, Zilleruelo GE, Abitbol C, Montane B, Pardo V. Human immunodeficiency virus nephropathy. Pediatric Nephrology. 1993 Apr 1;7(2):220-225. https://doi.org/10.1007/BF00864411
Strauss, Jose ; Zilleruelo, Gaston E ; Abitbol, Carolyn ; Montane, Brenda ; Pardo, Victoriano. / Human immunodeficiency virus nephropathy. In: Pediatric Nephrology. 1993 ; Vol. 7, No. 2. pp. 220-225.
@article{dee01127e3794052a0265eccdd20fcbb,
title = "Human immunodeficiency virus nephropathy",
abstract = "Varying components of the syndrome of human immunodeficiency virus nephropathy (HIVN) have been described, the most pertinent including proteinuria/nephrotic syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic kidneys, rapid progression to end-stage renal disease (ESRD), and no response to treatment regimens. The diagnosis of HIVN requires identification of excessive proteinuria or albuminuria, determined by a total protein excretion on a timed urine collection or a high protein/creatinine ratio in a random specimen. Various pathological lesions have been found in HIVN. The lesion of focal and segmental sclerosis (FS/FSS) is most characteristic in adults and usually is associated with a rapid demise. FS/FSS also has been described in approximately one-half of the pediatric patients reported in the literature (31/64). Despite progression to ESRD, the clinical course in children with HIVN is less fulminant than in adults. Other reported histological findings include primarily mesangial hyperplasia as well as minimal change, focal necrotizing glomerulonephritis or lupus nephritis, and hemolytic uremic syndrome. In addition to glomerular pathology, interstitial findings of dilated tubules filled with a unique proteinaceous material, atrophied tubular epithelium, and interstitial cell infiltration are very common. On electron microscopy, most investigators have found tubuloreticular inclusion bodies in endothelial cells of glomerular capillaries. Treatment of patients who develop ESRD remains highly controversial. Most adult patients treated with hemodialysis have succumbed rapidly; peritoneal dialysis has been better tolerated. Transplantation in patients with HIV infection must be considered to be tentative, with reports of acceleration towards full blown acquired immunodeficiency syndrome in some and uneventful 5-year survival in others. The situation of the pediatric patient with HIVN remains unclear and awaits the benefit of experience.",
keywords = "Acquired immunodeficiency syndrome, Focal glomerulosclerosis, Human immunodeficiency virus, Nephropathy, Proteinuria",
author = "Jose Strauss and Zilleruelo, {Gaston E} and Carolyn Abitbol and Brenda Montane and Victoriano Pardo",
year = "1993",
month = "4",
day = "1",
doi = "10.1007/BF00864411",
language = "English",
volume = "7",
pages = "220--225",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Human immunodeficiency virus nephropathy

AU - Strauss, Jose

AU - Zilleruelo, Gaston E

AU - Abitbol, Carolyn

AU - Montane, Brenda

AU - Pardo, Victoriano

PY - 1993/4/1

Y1 - 1993/4/1

N2 - Varying components of the syndrome of human immunodeficiency virus nephropathy (HIVN) have been described, the most pertinent including proteinuria/nephrotic syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic kidneys, rapid progression to end-stage renal disease (ESRD), and no response to treatment regimens. The diagnosis of HIVN requires identification of excessive proteinuria or albuminuria, determined by a total protein excretion on a timed urine collection or a high protein/creatinine ratio in a random specimen. Various pathological lesions have been found in HIVN. The lesion of focal and segmental sclerosis (FS/FSS) is most characteristic in adults and usually is associated with a rapid demise. FS/FSS also has been described in approximately one-half of the pediatric patients reported in the literature (31/64). Despite progression to ESRD, the clinical course in children with HIVN is less fulminant than in adults. Other reported histological findings include primarily mesangial hyperplasia as well as minimal change, focal necrotizing glomerulonephritis or lupus nephritis, and hemolytic uremic syndrome. In addition to glomerular pathology, interstitial findings of dilated tubules filled with a unique proteinaceous material, atrophied tubular epithelium, and interstitial cell infiltration are very common. On electron microscopy, most investigators have found tubuloreticular inclusion bodies in endothelial cells of glomerular capillaries. Treatment of patients who develop ESRD remains highly controversial. Most adult patients treated with hemodialysis have succumbed rapidly; peritoneal dialysis has been better tolerated. Transplantation in patients with HIV infection must be considered to be tentative, with reports of acceleration towards full blown acquired immunodeficiency syndrome in some and uneventful 5-year survival in others. The situation of the pediatric patient with HIVN remains unclear and awaits the benefit of experience.

AB - Varying components of the syndrome of human immunodeficiency virus nephropathy (HIVN) have been described, the most pertinent including proteinuria/nephrotic syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic kidneys, rapid progression to end-stage renal disease (ESRD), and no response to treatment regimens. The diagnosis of HIVN requires identification of excessive proteinuria or albuminuria, determined by a total protein excretion on a timed urine collection or a high protein/creatinine ratio in a random specimen. Various pathological lesions have been found in HIVN. The lesion of focal and segmental sclerosis (FS/FSS) is most characteristic in adults and usually is associated with a rapid demise. FS/FSS also has been described in approximately one-half of the pediatric patients reported in the literature (31/64). Despite progression to ESRD, the clinical course in children with HIVN is less fulminant than in adults. Other reported histological findings include primarily mesangial hyperplasia as well as minimal change, focal necrotizing glomerulonephritis or lupus nephritis, and hemolytic uremic syndrome. In addition to glomerular pathology, interstitial findings of dilated tubules filled with a unique proteinaceous material, atrophied tubular epithelium, and interstitial cell infiltration are very common. On electron microscopy, most investigators have found tubuloreticular inclusion bodies in endothelial cells of glomerular capillaries. Treatment of patients who develop ESRD remains highly controversial. Most adult patients treated with hemodialysis have succumbed rapidly; peritoneal dialysis has been better tolerated. Transplantation in patients with HIV infection must be considered to be tentative, with reports of acceleration towards full blown acquired immunodeficiency syndrome in some and uneventful 5-year survival in others. The situation of the pediatric patient with HIVN remains unclear and awaits the benefit of experience.

KW - Acquired immunodeficiency syndrome

KW - Focal glomerulosclerosis

KW - Human immunodeficiency virus

KW - Nephropathy

KW - Proteinuria

UR - http://www.scopus.com/inward/record.url?scp=0027536081&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027536081&partnerID=8YFLogxK

U2 - 10.1007/BF00864411

DO - 10.1007/BF00864411

M3 - Article

VL - 7

SP - 220

EP - 225

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 2

ER -