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{{AIDS}}
__NOTOC__
{{CMG}}
'''For patient information, click [[AIDS (patient information)|here]]'''
==Overview==
{{HIV associated nephropathy}}
'''HIV-Associated Nephropathy''' (HIVAN) is a type of collapsing [[FSGS]].  Serious renal complication of advanced [[HIV]] infection and [[AIDS]] leading to chronic and eventually [[end stage renal failure]](ESRF).  HIVAN is caused by direct infection of the renal cells with the HIV-1 virus and leads to renal damage through the viral gene products.  It could also be caused by changes in the release of [[cytokines]] during HIV infection.
{{CMG}}{{APM}};{{AE}}{{SHA}}{{KW}}
==[[HIV associated nephropathy overview|Overview]]==


Usually occurs only in advanced disease and approximately 80%
==[[HIV associated nephropathy historical perspective|Historical Perspective]]==
of patients with HIVAN have a [[CD4]] count of less than 200.  HIVAN presents with [[nephrotic syndrome]] and progressive [[renal failure]].  Despite being a cause of chronic renal failure kidney sizes are usually normal or large.


==Incidence==
==[[HIV associated nephropathy pathophysiology|Pathophysiology]]==
Much more common in Black and African American patients with [[HIV]].  In the USA 12% of patients dying with [[AIDS]] have histologically proven HIVAN, the worldwide incidence amongst [[AIDS]] patients appears to be similar.  A South African study at [[Tygerberg Hospital]], [[Stellenbosch University]], has shown HIVAN histology in 33/61(54%) [[biopsies]] performed in HIV positive patients. 


Among black adults in the USA it is the third most common cause of ESRF.
==[[HIV associated nephropathy causes|Causes]]==


==Pathology==
==[[HIV associated nephropathy differential diagnosis|Differentiating HIV associated nephropathy from other Diseases]]==
Involves all components of the [[nephron]].  Typical findings are that of collapsing [[FSGS]] (Focal segmental glomerulosclerosis)and mycrocystic tubular dilatation.
 
==[[HIV associated nephropathy epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[HIV associated nephropathy risk factors|Risk Factors]]==
 
==[[HIV associated nephropathy screening|Screening]]==
 
==[[HIV associated nephropathy natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[HIV associated nephropathy history and symptoms|History and Symptoms]] | [[HIV associated nephropathy physical examination|Physical Examination]] |[[HIV associated nephropathy  diagnostic study of choice|Diagnostic Study of Choice]] | [[HIV associated nephropathy laboratory findings|Laboratory Findings]] | [[HIV associated nephropathy KUB x ray|KUB X Ray]] | [[HIV associated nephropathy CT|CT]] | [[HIV associated nephropathy MRI|MRI]] | [[HIV associated nephropathy ultrasound|Ultrasound]] | [[HIV associated nephropathy other imaging findings|Other Imaging Findings]] | [[HIV associated nephropathy other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
There is as yet inadeqaute data from randomised controlled trials.
[[HIV associated nephropathy medical therapy|Medical Therapy]] | [[HIV associated nephropathy surgery|Surgery]] | [[HIV associated nephropathy prevention|Prevention]] | [[HIV associated nephropathy cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[HIV associated nephropathy future or investigational therapies|Future or Investigational Therapies]]


Treatment with [[HAART]] and [[ACE inhibitors]]/[[Angiotensin receptor blockers]] has been shown to be beneficial and should be given to all patients unless otherwise contra-indicated.  General renoprotective measures and the treatment of the complications of nephrotic syndrome and renal failure are adjunctive. 
==Case Studies==


[[Corticosteroid]] treatment can be useful in patients who do not respond to the above treatment.  There is some evidence that [[cyclophosphamide]] might be helpful in selective cases, however further trials are required on both steroids and [[cyclophosphamide]] before these drugs can become standardised treatmen if at all.
[[HIV associated nephropathy case study one|Case #1]]


{{SIB}}


[[Category:Kidney diseases]]
[[Category:Kidney diseases]]
[[Category:HIV/AIDS]]
[[Category:Immune system disorders]]
[[category:viral diseases]]


{{WH}}
{{WH}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 11:34, 30 June 2020

For patient information, click here

HIV associated nephropathy Microchapters

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Overview

Historical Perspective

Pathophysiology

Causes

Differentiating HIV associated nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

KUB X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2];Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[3]Krzysztof Wierzbicki M.D. [4]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating HIV associated nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination |Diagnostic Study of Choice | Laboratory Findings | KUB X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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