Spontaneous Improvement of the Renal Function in a Patient with HIV-Associated Focal Glomerulosclerosis

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Abstract

Collapsing glomerulopathy is a pattern of renal injury that is seen in association with human immunodeficiency virus (HIV) infection. Patients with this HIV-associated nephropathy (HIVAN) present nephrotic syndrome and rapid deterioration of the renal function. There is no proven effective therapy for HIVAN, and the majority of the patients become dialysis dependent. We report a case of biopsy-proven HIVAN that showed spontaneous improvement of the renal function.

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Most cited references 2

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HIV-associated nephropathy.

Mary E. Klotman (1999)

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Edema and acute renal failure.

Michele Andreucci, Stefano Federico, Vittorio E Andreucci (2001)

Acute renal failure (ARF) with overhydration and edematous state may follow Acute endocapillary proliferative glomerulonephritis and extracapillary glomerulonephritis, because of reduction of the glomerular capillary area available for filtration. But ARF may also be observed in edematous patients with minimal change nephrotic syndrome; it may require dialysis until recovery and is attributable to some of the following factors: (1) ischemic renal injury, (2) hypovolemia, (3) interstitial edema with tubular collapse, (4) redistribution of renal blood flow (RBF) from cortical to juxtaglomerular nephrons, (5) decrease of capillary filtration coefficient (Kf), (6) use of nonsteroidal antiinflammatory drugs. Congestive heart failure also leads to prerenal azotemia and edema formation secondary to salt retention. Multiple organ dysfunction syndrome (MODS) is frequently associated with ARF; but edema occurs even without ARF in septic patients with severe inflammatory response syndrome (SIRS). ARF may follow severe burns; burned patients are frequently edematous because of a rapid leak of fluid from the vascular bed into the wound; edema in undamaged areas occurs in the 'flow phase', because of a fall of oncotic pressure because of massive loss of plasma proteins into the wound. Edema must be treated with diuretics or by dialysis.

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Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 2002

Publication date (Print): August 2002

Publication date (Electronic): 02 August 2002

Volume: 22

Issue: 4

Pages: 369-371

Affiliations

Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain

Article

Publisher ID: 65229 Other ID: Am J Nephrol 2002;22:369–371

DOI: 10.1159/000065229

PubMed ID: 12169870

SO-VID: da7548eb-b8c4-4823-9197-e8d370776367

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Spontaneous Improvement of the Renal Function in a Patient with HIV-Associated Focal Glomerulosclerosis

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Abstract

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Karger: Nephrology

Most cited references 2

HIV-associated nephropathy.

Edema and acute renal failure.

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