D'Agati V, Appel G B
Department of Pathology, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
Semin Nephrol. 1998 Jul;18(4):406-21.
Renal complications of HIV infection are clinically and morphologically diverse. These may affect the glomerular, tubulointerstitial, and vascular compartments. Tubulointerstitial injury predominates in most autopsy-based studies, whereas glomerular disease is most frequently identified in biopsy-based studies. The most common glomerular lesion is HIV-associated focal segmental glomerulosclerosis and related mesangiopathies (collectively termed HIV-associated nephropathy). Increasingly, a variety of immune complex-mediated glomerular diseases such as membranoproliferative glomerulonephritis, IgA nephropathy and lupus-like nephritis, as well as hemolytic uremic syndrome/thrombotic thrombocytopenic purpura have been reported. The spectrum of tubulointerstitial lesions includes acute tubular necrosis, interstitial nephritis, diffuse infiltrative lymphocytosis syndrome, renal infection, and neoplasms including lymphoma and Kaposi's sarcoma. The pathological features of these conditions are reviewed with emphasis on clinical-pathological correlations and pathogenesis.
HIV感染的肾脏并发症在临床和形态学上具有多样性。这些并发症可能影响肾小球、肾小管间质和血管部分。在大多数基于尸检的研究中，肾小管间质损伤占主导地位，而在基于活检的研究中，肾小球疾病最常被发现。最常见的肾小球病变是HIV相关的局灶节段性肾小球硬化及相关的系膜病变（统称为HIV相关肾病）。越来越多的各种免疫复合物介导的肾小球疾病，如膜增生性肾小球肾炎、IgA肾病和狼疮样肾炎，以及溶血尿毒综合征/血栓性血小板减少性紫癜也有报道。肾小管间质病变的范围包括急性肾小管坏死、间质性肾炎、弥漫性浸润性淋巴细胞增多综合征、肾脏感染以及包括淋巴瘤和卡波西肉瘤在内的肿瘤。本文将对这些病症的病理特征进行综述，重点关注临床病理相关性和发病机制。
