Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
Curr HIV/AIDS Rep. 2012 Sep;9(3):187-99. doi: 10.1007/s11904-012-0125-9.
Antiretroviral therapy has been immensely successful in reducing the incidence of opportunistic infections and death after HIV infection. This has resulted in heightened interest in noninfectious comorbidities including kidney disease. Although HIV-associated nephropathy, the most ominous kidney disease related to the direct effects of HIV, may be prevented and treated with antiretrovirals, kidney disease remains an important issue in this population. In addition to the common risk factors for kidney disease of diabetes mellitus and hypertension, HIV-infected individuals have a high prevalence of other risk factors, including hepatitis C and exposure to antiretrovirals and other medications. Therefore, the differential diagnosis is vast. Early identification (through efficient screening) and prompt treatment of kidney disease in HIV-infected individuals are critical to lead to better outcomes. This review focuses on clinical and epidemiological issues, treatment strategies (including dialysis and kidney transplantation), and recent advances among kidney disease in the HIV population.
抗逆转录病毒疗法在降低 HIV 感染后机会性感染和死亡的发生率方面取得了巨大成功。这导致人们对非传染性合并症（包括肾脏疾病）产生了浓厚的兴趣。尽管与 HIV 直接作用相关的最严重的肾脏疾病——HIV 相关性肾病可以通过抗逆转录病毒药物来预防和治疗，但肾脏疾病仍然是这一人群中的一个重要问题。除了糖尿病和高血压等导致肾脏疾病的常见危险因素外，HIV 感染者还存在其他多种危险因素，包括丙型肝炎以及接触抗逆转录病毒药物和其他药物。因此，鉴别诊断范围广泛。早期识别（通过有效的筛查）和及时治疗 HIV 感染者的肾脏疾病对于获得更好的结果至关重要。本文综述重点介绍了 HIV 人群中肾脏疾病的临床和流行病学问题、治疗策略（包括透析和肾移植）以及最新进展。
