Renal disease in HIV patients: Difference between revisions
From IDWiki
m (Text replacement - "== Presentation" to "== Clinical Manifestations") |
m (Aidan moved page Renal disease in HIV to Renal disease in HIV patients without leaving a redirect) |
Latest revision as of 10:21, 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
