HIV-infected patients may present with a variety of patterns of renal involvement.
Acute renal failure is common and most often a result of
sepsis,
hypotension and nephrotoxic agents. It is potentially avoidable, and support through the period of
renal failure may lead to resolution of the renal dysfunction.
HIV-associated nephropathy is a unique pattern of sclerosing glomerulopathy that ranges in prevalence form 1 to 10 per cent of the HIV infected population in different geographic locales. This complication of
HIV infection will likely present a growing challenge to the medical community as
HIV infection continues to spread worldwide. Deciphering the pathogenitic mechanisms of this most rapidly progressive form of
focal segmental glomerulosclerosis is not only clinically relevant, but will hopefully provide valuable insights into the medication of the more common idiopathic form of the disease. The potential for improved renal survival of patients with
HIV-associated nephropathy ahs become more realistic with the development and the use of
antiretroviral agents, as well as studies on the role of immunosuppression and
Angiotensin Converting Enzyme (ACE) inhibition in this population.