Clinical manifestations of HIV nephropathya

Clinical manifestations of HIV nephropathy summarized as follows: severe proteinuria, azotemia, water, electrolyte disorder, gross hematuria, normal blood pressure, kidney, normal or increased, rapid-progressive renal insufficiency. HIV nephropathy with normal blood pressure to become a distinctive feature, the reason difficult to explain. Urine sediment examination often showed severe proteinuria, oval body fat and fat urine. A large number of mega-wax-like tube is HIV nephropathy is characterized by. The increase may be due to kidney:

① rapid progress of the disease, there is not enough time for all of glomerular sclerosis are, fibrosis;

② different from other chronic renal failure, HIV nephropathy showed significant glomerular expansion and numerous micro-like vesicles; ③ interstitial edema, a sharp reduction in serum albumin, with moderate proteinuria (<10mg>

2. Water, electrolyte and acid-base balance disorders in patients with advanced AIDS, water and electrolyte disorders are common. HIV infection in patients with hyponatremia are the most common dielectric disorder inpatients hyponatremia were up 36% a 56%. In these patients, fluid loss from the gastrointestinal tract caused by low blood volume is the most common causes of hyponatremia. Adrenal insufficiency is caused by another reason for hyponatremia. While the autopsy report is often adrenal pathological changes, but clinically less than 5% of patients showed significant adrenal dysfunction. Hyponatremia, hyperkalemia, non-anion gap metabolic acidosis, low blood volume, renal salt loss, as well as the performance of mild renal insufficiency often mixed there.

HIV infected persons in the course of treatment, drugs is another cause of water and electrolyte disorders an important reason, and adrenal insufficiency can cause similar abnormalities. Has been found to accept the administration of parenteral pentamidine in patients with hyperkalemia may occur and non-anion gap metabolic acidosis. Amphotericin B and high hypernatremia, hypokalemia, hypomagnesemia, renal tubular acidosis and renal insufficiency related to. With AIDS-related cancer chemotherapy drugs, it can directly through the renal toxicity or persistent vomiting, diarrhea caused by gastrointestinal fluid loss caused by water and electrolyte disturbance.

3. Acute renal failure with acute renal failure occurred in 20% ~ 40% of AIDS, this is one of the complications of HIV infection. May be secondary to inadequate fluid intake or excessive fluid loss of the gastrointestinal tract caused by prerenal azotemia. Hypertension, sepsis or application of drug-induced nephrotoxicity renal ischemia can lead to renal tubular necrosis. Acute interstitial nephritis is HIV-related illness caused by drug therapy is another complication.

Opportunistic infections, lymphoma, or Kaposi's sarcoma of the kidney substance abuse and abuse of narcotic induced subcutaneous amyloidosis may also lead to interstitial nephritis. Other kidney diseases, such as hepatitis B induced membranous glomerulonephritis, secondary bacterial infection of acute glomerulonephritis, from CMV, fungi, Mycobacterium direct result of renal parenchymal infection and hemolytic uremic a comprehensive Zheng, are related to HIV infection related to renal insufficiency.