Changing spectrum of renal disease in HIV infection

Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART). R...

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Vydané v:Deutsche medizinische Wochenschrift (1946) Ročník 138; číslo 38; s. 1887
Hlavní autori: Jung, O, Haack, H S, Brodt, H-R, Grützmacher, P, Geiger, H, Amann, K, Gröne, H-J, Bickel, M
Médium: Journal Article
Jazyk:German
Vydavateľské údaje: Germany 01.09.2013
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ISSN:1439-4413, 1439-4413
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Abstract Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART). Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period). 69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease. The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.
AbstractList Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART).BACKGROUND AND OBJECTIVERenal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART).Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period).PATIENTS AND METHODSRetrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period).69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease.RESULTS69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease.The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.CONCLUSIONThe underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.
Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART). Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period). 69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease. The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.
Author Brodt, H-R
Bickel, M
Gröne, H-J
Haack, H S
Jung, O
Amann, K
Grützmacher, P
Geiger, H
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/24022452$$D View this record in MEDLINE/PubMed
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Snippet Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including...
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StartPage 1887
SubjectTerms Adenine - adverse effects
Adenine - analogs & derivatives
Adenine - therapeutic use
Adult
AIDS-Associated Nephropathy - diagnosis
AIDS-Associated Nephropathy - drug therapy
AIDS-Associated Nephropathy - epidemiology
AIDS-Associated Nephropathy - pathology
Amyloidosis - diagnosis
Amyloidosis - epidemiology
Amyloidosis - pathology
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - adverse effects
Biopsy
Cohort Studies
Cross-Sectional Studies
Diabetic Nephropathies - diagnosis
Diabetic Nephropathies - epidemiology
Diabetic Nephropathies - pathology
Female
Follow-Up Studies
Germany
Glomerulonephritis - diagnosis
Glomerulonephritis - epidemiology
Glomerulonephritis - pathology
Humans
Hypertension, Renal - diagnosis
Hypertension, Renal - epidemiology
Hypertension, Renal - pathology
Immune Complex Diseases - diagnosis
Immune Complex Diseases - epidemiology
Immune Complex Diseases - pathology
Kidney - pathology
Male
Middle Aged
Nephritis - diagnosis
Nephritis - epidemiology
Nephritis - pathology
Organophosphonates - adverse effects
Organophosphonates - therapeutic use
Retrospective Studies
Serum Amyloid A Protein - metabolism
Tenofovir
Title Changing spectrum of renal disease in HIV infection
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