CASE: A 23-year-old nulliparous, black female presented at 13 weeks gestation with a history of
HIV-associated nephropathy and
anemia. She had a CD4 count of 350/mm(3), a total urinary
protein of 1.7 g/day, and a serum
creatinine of 4.8 mg/dl. The patient was begun on
zidovudine, 500 mg daily, and
erythropoietin, 4,000 units weekly. At 23 weeks gestation, when she developed
hypertension, a total urinary
protein of 3.4 g/day, and a serum
creatinine of 4.4 mg/dl, she was hospitalized. Her renal function continued to deteriorate, requiring
hemodialysis. At 29-4/7 weeks, she developed
preterm labor, for which she was placed on
indomethacin. Four days later, at 30 weeks gestation, she delivered a viable male infant.
CONCLUSION: