Räz H R, Nickeleit V, Mihatsch M J, Colombi A
Abteilung für Nephrologie, Kantonsspital Luzern.
Schweiz Med Wochenschr. 1998 Nov 21;128(47):1850-6.
We describe the frist reported case in Switzerland of HIV-associated nephropathy (HIVAN). HIVAN shows a typical combination of clinical findings: black race, proteinuria, large hyper-echogenic kidneys, normal blood pressure, positive HIV serology and no autoantibodies. The histologic findings are typical: focal segmental glomerulosclerosis of the collapsing variant, often with marked interstitial nephritis. The disease normally appears before AIDS symptoms develop and follows a very aggressive course to end-stage renal disease. Therapy consists of a combination of nucleoside reverse transcriptase and proteinase inhibitors, ACE inhibitors, and possibly steroids. In end-stage renal disease patients can be managed by haemodialysis, continuous ambulatory peritoneal dialysis (CAPD) or kidney transplantation.
我们描述了瑞士首例报告的与HIV相关的肾病（HIVAN）病例。HIVAN具有典型的临床症状组合：黑人种族、蛋白尿、肾脏高回声增大、血压正常、HIV血清学阳性且无自身抗体。组织学表现也很典型：塌陷型局灶节段性肾小球硬化，常伴有明显的间质性肾炎。该疾病通常在艾滋病症状出现之前就已出现，并且进展为终末期肾病的过程非常迅速。治疗包括核苷类逆转录酶抑制剂和蛋白酶抑制剂、ACE抑制剂联合使用，可能还需要使用类固醇。对于终末期肾病患者，可以通过血液透析、持续性非卧床腹膜透析（CAPD）或肾移植进行治疗。
