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人类免疫缺陷病毒(HIV)感染与肾脏

Human immunodeficiency virus (HIV) infection and the kidney.

作者信息

Glassock R J, Cohen A H, Danovitch G, Parsa K P

机构信息

Department of Medicine, Harbor-UCLA Medical Center, Torrance 90509.

出版信息

Ann Intern Med. 1990 Jan 1;112(1):35-49. doi: 10.7326/0003-4819-112-1-35.

Abstract

Since the first report on the acquired immunodeficiency syndrome (AIDS) in 1981, organ involvement of AIDS has increased. We discuss the effect of human immunodeficiency virus (HIV) infection, the causative agent of AIDS, on the field of nephrology. Hyponatremia, the commonest fluid and electrolyte abnormality, is caused by various pathophysiologic mechanisms, including adrenal insufficiency. The renal parenchymal complications are diverse, but a new entity, HIV-associated nephropathy, is becoming recognized because of its characteristic clinical and pathologic features, including the fact that it causes irreversible renal failure. HIV infection in patients with end-stage renal failure, both before and after initiation of maintenance dialysis, is a significant problem. The present methods of preventing spread of virus in dialysis units seem successful. Few patients who are infected with HIV or who have AIDS have had renal transplantation, although unsuspected viral infection of cadaveric organs remains a concern.

摘要

自1981年首次报告获得性免疫缺陷综合征(艾滋病)以来,艾滋病累及器官的情况有所增加。我们讨论了艾滋病病原体人类免疫缺陷病毒(HIV)感染对肾脏病领域的影响。低钠血症是最常见的液体和电解质异常,由多种病理生理机制引起,包括肾上腺功能不全。肾实质并发症多种多样,但一种新的疾病——HIV相关性肾病,因其特征性的临床和病理表现,包括导致不可逆肾衰竭这一事实,正逐渐被人们所认识。终末期肾衰竭患者在开始维持性透析之前和之后的HIV感染都是一个重大问题。目前在透析单位预防病毒传播的方法似乎是成功的。虽然尸体器官未被察觉的病毒感染仍是一个令人担忧的问题,但很少有感染HIV或患有艾滋病的患者接受肾移植。

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