Abstract | BACKGROUND: METHODS: We analysed clinical features and outcome of 57 patients with histologically proven HIVAN diagnosed between 2000 and 2009 in four teaching hospitals in Paris, France. RESULTS: This series was characterized by median age of 41 years (18-58), frequent African origin (87%), severe renal dysfunction [estimated glomerular filtration rate (eGFR) 20 mL/min/1.73m(2) (1-68)], high-grade proteinuria [4.1 g/day (0.6-16.8)], high proportion of sclerotic glomeruli [31.5% (0-95)], high HIV load [4.5 log copies/mL (0-6.7)] and low CD4+ count [127/mm(3) (3-713)]. Nevertheless, a non-negligible proportion of patients did not present with these typical features. Follow-up data were available for 51 patients. ESRD occurred in 30 patients (58.8%). Median renal survival was 40 months. Baseline characteristics significantly associated with ESRD were as follows: severity of renal dysfunction, percentage of sclerotic glomeruli, time from HIV infection to HIVAN diagnosis longer than 1 year and prior exposure to antiretroviral drugs. There was an insignificant trend towards better renal outcome being associated with viral suppression during follow-up. Use of renin-angiotensin system (RAS) blockers was associated with higher renal survival (P < 0.05). CONCLUSION: Despite HAART, HIVAN led to ESRD in more than half of the cases. Early recognition of the disease is crucial to start HAART and RAS blockers before irreversible renal injury.
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Authors | Naïke Bigé, Fanny Lanternier, Jean-Paul Viard, Prochore Kamgang, Eric Daugas, Caroline Elie, Kaoutar Jidar, Francine Walker-Combrouze, Marie-Noelle Peraldi, Corinne Isnard-Bagnis, Aude Servais, Olivier Lortholary, Laure-Hélène Noël, Guillaume Bollée |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 27
Issue 3
Pg. 1114-21
(Mar 2012)
ISSN: 1460-2385 [Electronic] England |
PMID | 21745806
(Publication Type: Journal Article, Multicenter Study)
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Topics |
- AIDS-Associated Nephropathy
(diagnosis, etiology)
- Adolescent
- Adult
- Antiretroviral Therapy, Highly Active
(adverse effects)
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
- HIV Infections
(complications, drug therapy, pathology)
- HIV-1
- Humans
- Kidney Failure, Chronic
(etiology, mortality, pathology)
- Male
- Middle Aged
- Prognosis
- Renin-Angiotensin System
- Retrospective Studies
- Survival Rate
- Young Adult
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