HIV-associated nephropathy

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  • 10% of HIV-infected p'ts
    • Blacks, IV drug abuse, homosexuals
    • Nephrotic syndrome
    • Rapid progression to ESRD
    • Pathology
      • Most commonly focal segmental glomerulosclerosis (collapsing glomerulopathy)
      • 2nd commonly membranoproliferative GN
      • Less commonly diffuse proliferative GN, ~IgA nephropathy, minimal change dis., and membranous or mesangioproliferative GN
      • Podocyte hyperplasia
      • Microcystic dilatation of renal tubules
      • Tubuloreticular inclusions in endothelial cells
  • Treatment
    • ACEI or ARB
    • Dialysis
    • Renal transplantation
    • Antiretroviral therapy