Burns G C, Matute R, Onyema D, Davis I, Toth I
Department of Medicine, St Vincent's Hospital and Medical Center of New York, NY.
Am J Kidney Dis. 1994 Mar;23(3):441-3. doi: 10.1016/s0272-6386(12)81009-2.
The most common chronic nephropathy seen with human immunodeficiency virus (HIV) infection is characterized by heavy proteinuria and rapid deterioration of renal function. We here report the findings in an HIV-seropositive patient with nephrotic-range proteinuria and biopsy-proven HIV-associated nephropathy treated with the angiotensin-converting enzyme (ACE) inhibitor, fosinopril. During treatment periods, the patient demonstrated a significant decrement in 24-hour urinary protein excretion without change in renal function. The patient acted as her own control. After discontinuation of the drug, the 24-hour protein excretion deteriorated to pretreatment levels. ACE inhibition has been reported to decrease proteinuria and to have a beneficial influence on the progression of renal failure in diabetic and nondiabetic renal disease. To date, there is no known therapy for HIV-associated nephropathy. Our preliminary results in this patient suggest the need for long-term studies to assess whether this form of therapy can improve proteinuria over longer periods and, at the same time, ameliorate the progressive form of nephropathy seen in selected HIV-seropositive patients.
人类免疫缺陷病毒（HIV）感染最常见的慢性肾病表现为大量蛋白尿和肾功能迅速恶化。我们在此报告一名HIV血清反应阳性患者的研究结果，该患者患有肾病范围蛋白尿且经活检证实为HIV相关性肾病，接受了血管紧张素转换酶（ACE）抑制剂福辛普利治疗。在治疗期间，患者24小时尿蛋白排泄显著减少，而肾功能无变化。该患者自身作为对照。停药后，24小时蛋白排泄恶化至治疗前水平。据报道，ACE抑制可减少蛋白尿，并对糖尿病和非糖尿病肾病的肾衰竭进展产生有益影响。迄今为止，尚无已知的HIV相关性肾病治疗方法。我们对该患者的初步结果表明，需要进行长期研究，以评估这种治疗形式能否在更长时间内改善蛋白尿，同时改善部分HIV血清反应阳性患者出现的进行性肾病。
