Volume 72 Number 3 May 2005	back to contents

Department of Nephrology, Mount Sinai Medical Center, New York, NY.

Address all correspondence to Ting-chi Lu, M.D., Mount Sinai Hospital, Department of Nephrology, Box 1243, One East 100th Street, New York, NY 10029.

Adapted from a Grand Rounds presentation to the Department of Medicine, Mount Sinai School of Medicine, New York, NY on October 14, 2003, and updated as of November 2004.

ABSTRACT

HIV-associated nephropathy (HIVAN) is an important cause of renal failure in HIV-1 seropositive patients. The disease is characterized by collapsing focal segmental glomerulosclerosis with marked podocyte proliferation, microcystic dilatation of the tubules and interstitial nephritis. Patients generally present with advanced HIV-1 infection, renal insufficiency and marked proteinuria. No serologic markers exist to diagnose HIVAN, and given the broad differential diagnosis for renal failure in these patients, renal biopsy should be performed. Viral infection of renal cells plays a central role in the pathogenesis of HIVAN. There is now compelling evidence that highly active antiretroviral therapy (HAART) is effective in preventing end-stage renal disease in patients affected with HIVAN. The efficacy of angiotensin-converting enzyme (ACE) inhibitors and prednisone has also been evaluated, but larger prospective studies are needed.

KEYWORDS

Nephropathy, glomerulosclerosis, nephritis.

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