Renal disease in HIV patients: Difference between revisions
From IDWiki
No edit summary |
m (Aidan moved page Renal disease in HIV to Renal disease in HIV patients without leaving a redirect) |
||
| (2 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
= Differential Diagnosis = |
== Differential Diagnosis == |
||
* Infection-related |
* Infection-related |
||
| Line 11: | Line 11: | ||
** Indinavir, sulfadiazine, and IV acyclovir: tubular obstruction from crystals |
** Indinavir, sulfadiazine, and IV acyclovir: tubular obstruction from crystals |
||
= HIV-associated nephropathy (HIVAN) = |
== HIV-associated nephropathy (HIVAN) == |
||
=== Clinical Manifestations === |
|||
== Presentation == |
|||
* Proteinuria, mild creatinine elevation, normal-seized echogenic kidneys on renal US |
* Proteinuria, mild creatinine elevation, normal-seized echogenic kidneys on renal US |
||
| Line 19: | Line 19: | ||
* Biopsy shows FSGS |
* Biopsy shows FSGS |
||
== Management == |
=== Management === |
||
* Treat the HIV with usual therapy |
* Treat the HIV with usual therapy |
||
Latest revision as of 14:21, 13 July 2024
Differential Diagnosis
- Infection-related
- HIV-associated nephropathy (HIVAN)
- Immune complex-mediated glomerular disease
- Coinfection with hepatitis B or C
- Treatment-related
- Tenofovir: Fanconi syndrome
- Pantamidine, foscarnet, and aminoglycosides: ATN
- Indinavir, sulfadiazine, and IV acyclovir: tubular obstruction from crystals
HIV-associated nephropathy (HIVAN)
Clinical Manifestations
- Proteinuria, mild creatinine elevation, normal-seized echogenic kidneys on renal US
- Usually have a detectable viral load, and decreased CD4 <200
- Biopsy shows FSGS
Management
- Treat the HIV with usual therapy
- Steroids for 8 to 12 weeks
- ACEi/ARB as tolerated
