Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Am Soc Nephrol. 2013 Jul;24(8):1204-8. doi: 10.1681/ASN.2012070665. Epub 2013 Apr 4.
The renal manifestations of patients infected with HIV are diverse. Patients may have podocytopathies ranging from a minimal-change-type lesions to FSGS or collapsing glomerulopathy. Furthermore, such patients produce a variety of autoantibodies without clinical signs of the disease. Antiretroviral drugs also cause renal injury, including crystals and tubular injury, acute interstitial nephritis, or mitochondrial toxicity. In these circumstances, it is essential to perform a renal biopsy for diagnosis and to guide treatment. Here we describe a patient with HIV who presented with AKI and hematuria without concomitant systemic manifestations. Renal biopsy elucidated the cause of acute deterioration of kidney function.
HIV 感染者的肾脏表现多种多样。患者可能患有从微小病变型病变到 FSGS 或塌陷性肾小球病的足细胞病。此外,这些患者还会产生多种自身抗体,但没有疾病的临床迹象。抗逆转录病毒药物也会导致肾脏损伤,包括结晶和肾小管损伤、急性间质性肾炎或线粒体毒性。在这些情况下,进行肾活检以明确诊断和指导治疗至关重要。本文描述了一位 HIV 感染者,其表现为 AKI 和血尿,无伴随的全身表现。肾活检明确了肾功能急性恶化的原因。