Pernasetti María Marta, Chiurchiu Carlos, Fuente Jorge de la, Arteaga Javier de, Douthat Walter, Bardosy Cecilia, Zarate Abel, Massari Pablo U
Servicio de Nefrología y Carrera de Posgrado, Universidad Católica de Córdoba, Argentina.
Medicina (B Aires). 2010;70(3):247-53.
Several renal complications may occur during HIV infection, especially in advanced stages related to HIV, to other infectious agents and/or drugs. Little is known about the prevalence of renal diseases that may occur as a complication of or related to HIV infection in asymptomatic patients. This is a single center cross-sectional study of asymptomatic HIV(+) patients referred to a nefrology care service at an Argentine hospital to look for the presence of renal abnormalities. Fifty two consecutive patients were studied between April and November 2008. Patients underwent plasma and urine analysis, ultrasound, and kidney biopsy as needed. Mean age was 39.9 +/- 10.6 years, 88% were male, time from HIV diagnosis 53.2 +/- 41.2 months (2-127); 71% had HIV-disease and 77% were on antiretroviral therapy. Mean plasma HIV-RNA copies number was 7.043 +/- 3.322 and CD4+ cell count: 484 +/- 39. Pathologic findings in urine analysis were present in 30.7% of patients: albuminuria 16.6%, microscopic hematuria 11.5%, hypercalciuria 10.8% and crystalluria 6%. Mean glomerular filtration rate was 102.2 +/- 22.95 ml/min (34-149) and 41% of patients could be classified in stages 1 to 3 of chronic kidney disease. Renal abnormalities prevaled in older patients without relationship with presence of HIV-disease. Two patients were biopsied and the findings included: tubulointerstitial nephritis with presence of crystal deposition in one and IgA nephropathy in the other. No HIV-associated nephropathy was detected. The broad spectrum and the high prevalence of lesions found in this series suggest that asymptomatic HIV-infected patients should routinely undergo renal evaluation.
在HIV感染期间可能会出现几种肾脏并发症，尤其是在与HIV、其他感染因子和/或药物相关的晚期阶段。对于无症状患者中可能作为HIV感染并发症或与之相关的肾脏疾病的患病率知之甚少。这是一项在阿根廷一家医院对转至肾脏病护理服务部门的无症状HIV阳性患者进行的单中心横断面研究，旨在寻找肾脏异常情况。2008年4月至11月期间对52例连续患者进行了研究。患者根据需要接受了血浆和尿液分析、超声检查以及肾脏活检。平均年龄为39.9±10.6岁，88%为男性，自HIV诊断以来的时间为53.2±41.2个月（2 - 127个月）；71%患有HIV疾病，77%正在接受抗逆转录病毒治疗。血浆HIV - RNA拷贝数平均为7.043±3.322，CD4 +细胞计数为484±39。30.7%的患者尿液分析有病理发现：蛋白尿16.6%，镜下血尿11.5%，高钙尿症10.8%，结晶尿6%。平均肾小球滤过率为102.2±22.95 ml/分钟（34 - 149），41%的患者可归类为慢性肾脏病1至3期。肾脏异常在老年患者中更为普遍，与HIV疾病的存在无关。对两名患者进行了活检，结果包括：一例为肾小管间质性肾炎伴晶体沉积，另一例为IgA肾病。未检测到HIV相关性肾病。本系列中发现的病变范围广泛且患病率高，表明无症状HIV感染患者应常规进行肾脏评估。
