The renal pathological findings in Japanese HIV-infected individuals with CKD: a clinical case series from a single center View Full Text


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Article Info

DATE

2017-06-08

AUTHORS

Masaki Hara, Kumiko Momoki, Masamitsu Ubukata, Akihito Ohta, Akiko Tonooka, Minoru Ando

ABSTRACT

BackgroundChronic kidney diseases (CKD) have emerged as a significant cause of morbidity and mortality in patients infected with human immunodeficiency virus (HIV). However, the detailed study of renal pathological findings currently remains unclear in these Japanese patients.MethodsA retrospective cohort study was undertaken to investigate renal pathological findings between January 1996 and July 2016. Our study included 20 Japanese HIV-infected patients with CKD; 10 cases had undergone renal biopsies, and 10 cases had undergone autopsies, respectively. Moreover, in the 10 biopsied patients, their clinical courses as well as renal outcomes after renal biopsy were also reviewed.ResultsAll of the patients had received combination antiretroviral therapy (cART). The 10 biopsy cases (mean age, 54 ± 14 years and duration of cART, 8 ± 5 years) included three cases of diabetic nephropathy (DMN), two of IgA nephropathy, two of cART-induced tubulointerstitial nephritis (TIN), one of minimal change disease, one case of only finding intrarenal arterioles, and one case without abnormal findings. Among those patients, their clinical courses were preferable except for in the DMN cases. In the autopsy cases (mean age, 52 ± 10 years and duration of cART, 5 ± 5 years), no distinct mesangial or membranous abnormalities were detected. Mild to moderate tubulointerstitial atrophies were observed in six cases. Intrarenal arteriosclerosis was identified in nine cases, and the proportion of global glomerulosclerosis seen was 8.4 ± 12.5%/100 glomeruli.ConclusionDMN and cART-induced TIN was noted in the biopsy cases. In the autopsy cases, renal arteriosclerosis, global glomerulosclerosis, and tubulointerstitial atrophy were remarkable. Early diagnosis of kidney diseases should be crucial to introduce optimal management, including controlling rigorous comorbidities and appropriate use of cART, to prevent further progression of CKD. More... »

PAGES

68-77

References to SciGraph publications

  • 2008-09-14. MYH9 is a major-effect risk gene for focal segmental glomerulosclerosis in NATURE GENETICS
  • 2009-10. The nephrotoxic effects of HAART in NATURE REVIEWS NEPHROLOGY
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    http://dx.doi.org/10.1007/s10157-017-1425-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1085934806

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28597149


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