HIV Kidneys

Question 1

What can cause renal involvement in HIV patients?

Answer 1

Treatment or the virus itself

Protease inhibitors such as indinavir can precipitate intratubular crystal obstruction.

Question 2

What percentage of end-stage renal failure cases in the United States is accounted for by HIV-associated nephropathy (HIVAN)?

Answer 2

Up to 10%

HIVAN is a significant contributor to end-stage renal failure.

Question 3

What is the treatment of choice for HIV-associated nephropathy?

Answer 3

Antiretroviral therapy

All HIV-diagnosed patients should be on antiretroviral therapy.

Question 4

What should be checked if a patient is already taking antiretroviral therapy?

Answer 4

Adherence

It is crucial to ensure patients are compliant with their treatment.

Question 5

List the five key features of HIV-associated nephropathy (HIVAN).

Answer 5

• Massive proteinuria resulting in nephrotic syndrome
• Normal or large kidneys
• Focal segmental glomerulosclerosis with focal or global capillary collapse on renal biopsy
• Elevated urea and creatinine
• Normotension

Question 6

True or False: HIV-associated nephropathy typically presents with hypotension.

Answer 6

False

HIVAN is characterized by normotension.

Question 7

Fill in the blank: The renal biopsy in HIV-associated nephropathy may show __________ with focal or global capillary collapse.

Answer 7

focal segmental glomerulosclerosis

Question 8

What renal condition results from massive proteinuria in HIV-associated nephropathy?

Answer 8

Nephrotic syndrome

Question 9

What laboratory findings are typically elevated in HIV-associated nephropathy?

Answer 9

Urea and creatinine