Jung O, Haack H S, Brodt H-R, Grützmacher P, Geiger H, Amann K, Gröne H-J, Bickel M
Medizinische Klinik III - Funktionsbereich Nephrologie, Goethe Universität, Frankfurt am Main.
Dtsch Med Wochenschr. 2013 Sep;138(38):1887-91. doi: 10.1055/s-0033-1349438. Epub 2013 Sep 10.
Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART).
Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period).
69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease.
The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.
肾脏疾病是HIV感染患者常见的并发症。这些患者肾脏疾病的病因和种类繁多，包括与HIV相关和与HIV无关的病因。我们的目的是评估抗逆转录病毒治疗（ART）下肾脏疾病分布的变化。
对1989年至2012年间因慢性进行性肾脏疾病在法兰克福HIV队列（FHC）接受肾活检的所有患者进行回顾性分析。定义了两个时间段：1989 - 2001年（早期）和2000 - 2012年（晚期）。
69例HIV感染患者接受了肾活检，大多数为白种男性（早期：22例患者，晚期：47例患者）。在整个观察期内，免疫复合物介导的肾小球肾炎（26.1%）、高血压（20.3%）和糖尿病肾病（20.3%）是慢性肾脏疾病最常见的病因。HIV相关肾脏疾病在第一阶段占主导，而高血压和糖尿病肾病在晚期诊断病例中占近50%。晚期常见其他类型的肾脏疾病包括肾AA淀粉样变性和替诺福韦相关肾病。
HIV感染患者肾脏疾病的潜在病理高度可变且不断演变。自高效抗逆转录病毒治疗（HAART）引入以来，与HIV无直接关系的肾脏疾病已成为主要病因，反映出在这个老龄化人群中合并症负担的增加。
