Acquired immunodeficiency syndrome (AIDS)--related renal disease

More than 87,000 patients with acquired immunodeficiency syndrome (AIDS) were reported to the Centers for Disease Control in the United States, of whom more than half died through January 1989. When the AIDS epidemic is considered worldwide, these numbers should be doubled at least [27]. Whereas electrolyte disorders and acute renal complications were recognized early on in the AIDS epidemic, it was not until 1984 that a nephropathy was described in patients with human immunodeficiency virus-Type 1 (HIV-1) (formerly called LAV/HTLV-III) infection [18, 30, 36]. This nephropathy was characterized, clinically, by heavy proteinuria or the nephrotic syndrome and a rapid progression to end-stage chronic renal failure and, pathologically, by an aggressive form of focal segmental glomerulosclerosis. The existence of an AIDS-related nephropathy was not readily accepted because of its uneven geographic distribution amongst areas severely affected by the AIDS epidemic [24, 48]. This brief review summarizes the clinical and pathologic features of AIDS-related nephropathy.