Renal ultrasound in acquired immune deficiency syndrome

Ten patients with clinical and laboratory features of acquired immune deficiency syndrome (AIDS) underwent renal ultrasonography prior to biopsy because of proteinuria, azotemia, or uremia. Four patients had a history of intravenous heroin abuse and were considered separately so as to exclude it as a cause of nephropathy. Histological examination revealed focal segmental glomerulosclerosis (FSGS), which in patients with AIDS is characterized by rapid progression to severe uremia (though FSGS can also occur in several other forms of renal disease). The authors recommend that AIDS-associated FSGS be considered as a cause of type I parenchymal disease and suggest that serial sonograms may be useful in monitoring progressive renal involvement.