HIV: renal involvement

Question 1

2 mechanisms of HIV causing renal impairment

Answer 1

1. directly due to virus
2. treatment related

Question 2

How can HIV treatments cause renal impairment?

Answer 2

Protease inhibitors (e.g. indinavir) can precipitate intratubular crystal obstruction.

Question 3

How is HIV-associated nephropathy (virus related not treatment related) renal impairment managed?

Answer 3

Make sure patient is taking antiretroviral therapy

check compliance

Question 4

Clinical features of HIV-associated nephropathy

Answer 4

• massive proteinuria resulting in nephrotic syndrome
• normal or large kidneys
• FSGS with focal or global capillary collapse on renal biopsy
• elevated urea and creatinine
• normotension