Cohen Scott D, Chawla Lakhmir S, Kimmel Paul L
Division of Nephrology, Department of Medicine, College of Physicians and Surgeons, Columbia University, Washington, District of Columbia, USA.
Curr Opin Crit Care. 2008 Dec;14(6):647-53. doi: 10.1097/MCC.0b013e3283186f43.
To present an overview of the epidemiology and etiology of acute kidney injury (AKI) in patients infected with human immunodeficiency virus (HIV).
HIV-infected patients are at an increased risk of developing AKI. Potential risk factors for the development of AKI in this patient population include increased HIV viral loads, reduced CD4 cell counts, hepatitis C virus coinfection, a history of diabetes, black race, male gender, and baseline chronic kidney and hepatic disease. Observational studies have found an increased morbidity and mortality in HIV-infected patients who develop AKI. There are diverse etiologies of AKI in HIV-infected patients, with increasing reports of highly active antiretroviral therapy-related nephropathy secondary to tenofovir nephrotoxicity. There have also been recent case reports of HIV-infected patients who develop a unique form of acute interstitial nephritis secondary to diffuse infiltrative lymphocytosis syndrome.
There are a variety of etiologies of AKI in HIV-infected patients. Prompt diagnosis and treatment of AKI is critical to help prevent morbidity and mortality in this patient population.
概述感染人类免疫缺陷病毒（HIV）患者急性肾损伤（AKI）的流行病学和病因。
HIV感染患者发生AKI的风险增加。该患者群体发生AKI的潜在危险因素包括HIV病毒载量增加、CD4细胞计数降低、丙型肝炎病毒合并感染、糖尿病史、黑人种族、男性以及基线慢性肾脏和肝脏疾病。观察性研究发现，发生AKI的HIV感染患者的发病率和死亡率增加。HIV感染患者发生AKI的病因多种多样，继发于替诺福韦肾毒性的高效抗逆转录病毒治疗相关肾病的报道日益增多。最近也有病例报告称，HIV感染患者继发弥漫性浸润性淋巴细胞增多综合征后出现一种独特形式的急性间质性肾炎。
HIV感染患者发生AKI的病因多种多样。对AKI进行及时诊断和治疗对于预防该患者群体的发病率和死亡率至关重要。
