[Extrarenal clearance in HIV-infected patients with chronic kidney failure. Experience in a hospital center]

In HIV-infected patients with end-stage renal failure maintenance dialysis raises multiple problems, the most important of these being the quality and duration of life in these patients and the risk of contaminating other HIV negative patients under dialysis and/or members of the medical-nursing staff. In this study the results obtained in 14 patients treated in one single centre over a 5-year period are analyzed. Nine patients (group I) had end-stage renal failure consecutive to HIV-associated nephropathy: 5 died after 2 to 30 months (mean 9.2 +/- 5.2) of dialysis, while 4 patients were alive at the end of the study with a mean follow-up of 23.8 +/- 8.8 months (5 to 50). Five patients (group II) had end-stage renal failure consecutive to a nephropathy unrelated to HIV: only 1 female patient died 29 months after she was found to be seropositive; the remaining 4 patients were alive at the end of the study with a mean 47.5 +/- 5.5 months (33 to 58) of follow-up. Ten patients were found to have a less than 8 g/dl Hb anaemia which was corrected in the 4 patients who received recombinant human erythropoietin. Out of the 9 patients treated with zidovudine (300 mg/day) 6 had haematological side-effects. Throughout this study, there was no contamination of HIV negative patients or members of the medical-nursing staff. In these 2 groups, the survival of HIV positive patients dialysed for chronic renal failure seems to have been conditioned by the stage of HIV infection at the time when maintenance dialysis was instituted.