HIV-Associated_Nephropathy

HIV-Associated_Nephropathy - SaleemBharmal 9/23/08

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Saleem Bharmal 9/23/08
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Association between HIV and renal disease first  reported in 1984 HIV-1 seropositive patients Renal syndrome characterized by progressive  renal failure and proteinuria Most common kidney biopsy finding was FSGS 
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HIV-1 seropositive Low CD4 counts (< 250) and/or other criteria for  AIDS Proteinuria, often in the nephrotic range Most patients have moderate to severe renal  insufficiency at the time of diagnosis Peripheral edema is uncommon Hypertension is rare Renal ultrasound shows echogenic kidneys that  are normal-to-large in size
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Collapsing form of Focal segmental  glomerulosclerosis (FSGS) Microcystic dilatation or renal tubules Globally sclerotic glomeruli  Lymphocytic interstitial infiltrates and Interstitial fibrosis Podocyte proliferation and loss of podocyte differentiation  markers Endothelial tubuloreticular inclusions seen on EM
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Only 40-50% are confirmed to be HIVAN by renal 
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HIV-Associated_Nephropathy - SaleemBharmal 9/23/08

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