Renal Dysfunction in HIV-1-infected Patients.

Area of Science:

• Nephrology
• Infectious Diseases
• Public Health

Background:

• Improved therapies for Human Immunodeficiency Virus type 1 (HIV-1) have increased patient survival.
• Longer survival with HIV-1 infection is associated with a growing prevalence of kidney disease.
• In 1999, renal disease affected approximately 14% of Black and 6% of White patients with HIV-1, with 10% experiencing renal failure.

Purpose of the Study:

• To highlight the increasing burden of kidney disease in HIV-1 infected patients.
• To identify common renal pathologies and drug-related renal toxicities in HIV-1 patients.
• To emphasize the importance of screening and intervention for renal disease in this population.

Main Methods:

• Review of patient survival data and renal disease prevalence in HIV-1 infected individuals.
• Identification of common glomerular diseases associated with HIV-1.
• Analysis of drug toxicity profiles, particularly indinavir, on renal function.

Main Results:

• Focal segmental glomerulosclerosis and immune complex glomerulonephritis are the most frequent glomerular diseases.
• Drug toxicity is a significant cause of renal issues, including acute renal failure and interstitial nephritis.
• Indinavir use is linked to crystalluria, nephrolithiasis, and interstitial nephritis.

Conclusions:

• Effective antiretroviral therapy and angiotensin antagonist medication are vital for managing focal segmental glomerulosclerosis.
• Proactive screening and timely intervention for renal disease can mitigate morbidity and mortality in HIV-1 patients.
• Addressing drug-induced nephrotoxicity is essential for comprehensive HIV-1 patient care.