Fifty-one adults with
HIV infection, including 20 chronic
hemodialysis patients with superimposed
HIV infection and 31 patients with
HIV-associated nephropathy requiring chronic maintenance
hemodialysis were followed to evaluate survival on outpatient dialysis in relation to the clinical stage of the
HIV infection. Regardless of when they contracted the
infection,
AIDS patients who required maintenance
hemodialysis had a poor prognosis. All 17 patients who developed
AIDS died after a mean of 93 +/- 32 days on
hemodialysis (median 30 days; range 2 to 540 days). On the other hand, 12 asymptomatic HIV carriers were alive after a mean follow-up on chronic
hemodialysis of 488 +/- 75 days (median 420 days; range 142 to 850 days); and five hemodialyzed patients with
ARC were alive after 564 +/- 191 days (median 420 days; range 150 to 1230 days). The data confirm the lack of effectiveness of maintenance
hemodialysis for prolonging life in patients with
AIDS. This dismal prognosis was evident whether
renal failure antedated
HIV infection or whether it was HIV-associated. In asymptomatic HIV carriers and in patients with
ARC, however, maintenance
hemodialysis provides meaningful, long-term life support.