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Renal Functional Reserve in Naïve HIV Patients.
Carlos G Musso1, Rossina Juarez2, W Belloso3
1Research Department, Hospital Italiano de Buenos Aires. Buenos Aires, Argentina.
Summary
Renal functional reserve (RFR) is preserved in HIV patients not yet on treatment, but it is significantly lower than in healthy individuals. This finding highlights potential kidney function changes in early HIV infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Renal functional reserve (RFR) is the kidney's ability to increase glomerular filtration rate (GFR) by at least 20% after stimulation.
- HIV-associated nephropathy can manifest as decreased GFR, nephrotic syndrome, and tubular dysfunction.
- Early detection of renal changes in HIV patients is crucial, especially those treatment-naive.
Purpose of the Study:
- To prospectively evaluate the renal functional reserve (RFR) in HIV-seropositive patients who have not yet started antiretroviral therapy.
Main Methods:
- Glomerular filtration rate (GFR) was measured using cimetidine-aided creatinine clearance (CACC).
- Renal functional reserve (RFR) was assessed using the method described by Hellerstein et al.
- The study included 12 treatment-naive HIV patients and 9 healthy volunteers.
Main Results:
- All 12 treatment-naive HIV patients demonstrated a positive RFR (24.8±2%).
- This RFR was significantly lower compared to the RFR observed in the 9 healthy control individuals (90.3 ± 5%).
Conclusions:
- Renal functional reserve is present in treatment-naive HIV patients.
- However, the RFR in this cohort is significantly diminished compared to seronegative healthy individuals, suggesting early renal impairment.
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