AIDS-associated nephropathy: 5-year retrospective morphologic analysis of 87 cases

Morphologic findings in the kidneys of 138 consecutive acquired immunodeficiency syndrome (AIDS) autopsies performed at the Mexico City General Hospital between 1986 and 1991 were studied. A total of 87 cases (63%) had renal disease, 62 cases presented glomerular alterations, and 80 cases showed tubulointerstitial damage. Glomerular collapse was seen in 30 cases (48%), mesangial expansion in 22 cases (35%), focal and segmental glomerulosclerosis in 20 cases (32%) and glomerular proliferation in only eight cases (11%). Nephrocalcinosis was seen in 25 cases (31%). Thirty-six cases (45%) presented tubulointerstitial infections: Mycobacterium tuberculosis in 19 cases (23%), Cryptococcus in 10 cases (12.5%), Cytomegalovirus CMV in eight cases (10%), Gram-negative bacteria in 3 cases (3.7%), and one case with histoplasmosis. In six cases the pathogens were multiple. Two cases showed infiltration of large-cell non-Hodgkin lymphoma. Based on the results obtained by autopsies, we conclude that in our country there is a high frequency of renal affection in AIDS patients. Clinically, this disease is infrequently diagnosed and not always related to the cause of death.