Consequently, The clinical indications for biopsy were nephrotic syndrome in 62 (47.7%), acute kidney injury in 13 (10%), systemic lupus nephritis in 14 (10.8 %), hypertension with significant protienureia (>1.0g/day) in 4 (3.1%), end stage renal disease in 4 (3.1%), HIV nephropathy in 1 (0.8%), hemolytic uremic syndrome in 1 (0.8%) and post transplanted renal disease in 27 (20.8%).
Clinical Indications for Renal Biopsy Nephrotic Syndrom 47% Acute Kidney Injury 10% Systemic Lupus Nephritis 11% Post Transplanted Kidney Disease 3% HUS 0.80% HIV Nephropathy 0.80% HPT with Proteinuria Non-Nephrotic Range 3.10% End Stage Renal Disease 3.10% Autosomal Dominant Polycystic Kidney Disease 0.80% Diabetic Nephropathy 2.30% Note: Table made from bar graph.
In approximately 15% and 5% of HIV-infected children with AIDS and those without AIDS, respectively, the disease progresses to HIV nephropathy
. HIV nephropathy
is more common in African American children than in others.
The nephrologists assessed "progressive nephropathy" via >3 gr/day proteinuria and interpreted in favor of HIV nephropathy
or focal segmentary glomerulosclerosis known as an immunological response to IE.
The statistically significant finding of more patients with renomegaly and associated increased cortical echogenicity may be ascribed to HIV nephropathy
, which usually causes diffuse renal cortical echogenicity as well as renal enlargement.
No specific treatment is available and HIV nephropathy carries a poor prognosis.
Ultrasound findings of HIV nephropathy include renal enlargement >13 cm in 20% of patients and increased cortical echogenicity, which is largely caused by tubulointerstitial abnormalities, in 75% of patients.
The researchers excluded any patients who had acute glomerulonephritis immune-mediated nephritis, overt diabetes, as well as patients who had HIV nephropathy
1 "HIV/AIDS and HIV Nephropathy
: State of the Science" Vol.
Other causes of renal failure included hypertension, chronic pyelonephritis, immunoglobulin A nephropathy, and HIV nephropathy
(only one of six patients tested was HIV seropositive).
A longitudinal scan through the right upper quadrant shows increased cortical echogenicity of the right kidney in this patient with known HIV, reflecting the presence of HIV nephropathy
Discuss the current state of HIV/AIDS, HIV nephropathy
, and the role of the nephrology nurse practitioner in prevention, diagnosis, health maintenance, and treatment.