HIV associated nephropathy natural history, complications and prognosis
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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: Krzysztof Wierzbicki M.D. [3]
Overview
Natural History
If left untreated, HIV-associated nephropathy will progress to end-stage renal disease in a few weeks to months.[1]
Complications
Possible complications that are associated with HIV-associated nephropathy include:
- End-stage renal disease
Prognosis
In the past, before the advent of HAART therapy, the prognosis of HIV-associated nephropathy was fatal. The mortality rate during this time was 100% within 6 months. Today, the prognosis with the availability of HAART therapy still remains grim, however, its availability has increased renal survival rate.
The following are favorable prognostic factors:
- Patients on HAART therapy
- Patients with low-grade proteinuria
- Patients who have a suppressed HIV-1 viral load
- Patients who express a normal renal echogenicity
- Patients with CD4 levels that between 200 and 500 cells/mm3
- Patients who have higher estimated glomerular filtration rates
The following are poor prognostics factors:
- Patients not receiving HAART therapy
- Patients with high-grade proteinuria
- Patients who have under suppressed HIV-1 viral load
- Patients who express a large renal echogenicity
- Patients who have CD4 levels that are below 200 cells/mm3
- Patients who have lower estimated glomerular filtration rates
The current first and second year survival rate of HIV-associated nephropathy is estimated to be around 63% and 43% respectively, with the use of HAART therapy.
References
- ↑ Atta MG, Lucas GM, Fine DM (2008). "HIV-associated nephropathy: epidemiology, pathogenesis, diagnosis and management". Expert Rev Anti Infect Ther. 6 (3): 365–71. doi:10.1586/14787210.6.3.365. PMID 18588500.