HIV associated nephropathy: Difference between revisions

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Revision as of 21:05, 30 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating HIV associated nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

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 {{HIV associated nephropathy}}
 {{CMG}}
-==Overview==
+==[[HIV associated nephropathy overview|Overview]]==
-'''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.
-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.
-==Pathophysiology==
+==[[HIV associated nephropathy classification|Classification]]==
-===Pathology===
-Involves all components of the [[nephron]].  Typical findings are that of collapsing [[FSGS]] (Focal segmental glomerulosclerosis)and mycrocystic tubular dilatation.
-==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]]==
+==[[HIV associated nephropathy differential diagnosis|Differentiating HIV associated nephropathy from other Diseases]]==
+==[[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 staging|Staging]] | [[HIV associated nephropathy history and symptoms|History and Symptoms]] | [[HIV associated nephropathy physical examination|Physical Examination]] | [[HIV associated nephropathy laboratory findings|Laboratory Findings]] | [[HIV associated nephropathy chest x ray|Chest X Ray]] | [[HIV associated nephropathy CT|CT]] | [[HIV associated nephropathy MRI|MRI]] | [[HIV associated nephropathy other imaging findings|Other Imaging Findings]] | [[HIV associated nephropathy other diagnostic studies|Other Diagnostic Studies]]
 ==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 primary prevention|Primary Prevention]] | [[HIV associated nephropathy secondary prevention|Secondary 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.
-[[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.
+==Case Studies==
+[[HIV associated nephropathy case study one|Case #1]]

HIV associated nephropathy: Difference between revisions

Revision as of 21:05, 30 September 2012

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