How is HIV nephropathy diagnosed?
Definitive diagnosis requires kidney biopsy, which demonstrates collapsing focal segmental glomerulosclerosis with associated microcystic tubular dilatation and interstitial inflammation.
What is a HIVAN?
HIV-associated nephropathy (HIVAN), the classic kidney disease associated with HIV infection, was first described in 1984 as a complication of AIDS [1-3], although HIVAN may also occur in patients with less advanced HIV infection or following acute seroconversion [4,5].
How is HIVAN treated?
Currently, cART remains the mainstay of treatment of HIVAN, either biopsy proven or clinically suspected. Other therapies including RAAS blockade and prednisone therapy, should be considered in the appropriate clinical context.
How does HIV cause FSGS?
HIVAN has a distinct histology, representing a collapsing form of focal segmental glomerulosclerosis (FSGS). The pathogenesis of HIVAN requires local HIV infection of the kidney, with the virus infecting tubular and glomerular epithelial cells.
What is membranous nephropathy?
Membranous nephropathy (MN) is a type of glomerular disease and is an autoimmune disease. An autoimmune disease is caused when your body’s defense system turns against you and harms your body when it should be protecting you. Your defense system is known as your immune system which is “turned on” by glomerular disease.
Is HIVAN reversible?
HIVAN is a treatable condition and there is good reason for optimism with regard to the prognosis of such patients.
Is Hivan reversible?
Why is it called membranous nephropathy?
Membranous nephropathy (MN) is a disorder where the body’s immune system attacks the filtering membranes in the kidney. These membranes clean waste products from the blood. Each kidney has thousands of tiny filtering units called glomeruli.
Who does membranous nephropathy affect?
Who gets Membranous Nephropathy? MN is most common in older-middle aged adults, in their 50s and 60s, though can occur earlier or later. It is rare in children. Men are affected more often than women, and it is much more common in Caucasians (versus blacks).
How does tenofovir cause renal failure?
Proximal tubular cell secretion of tenofovir explains the accumulation of the drug in these mitochondria-rich cells. Tenofovir nephrotoxicity is characterized by proximal tubular cell dysfunction that may be associated with acute kidney injury or chronic kidney disease.
What happens membranous nephropathy?
Membranous nephropathy (MEM-bruh-nus nuh-FROP-uh-thee) occurs when the small blood vessels in the kidney (glomeruli), which filter wastes from the blood, become damaged and thickened. As a result, proteins leak from the damaged blood vessels into the urine (proteinuria).
Can a person with HIV have diabetic nephropathy?
In addition, as patients with HIV infection age, comorbid kidney diseases such as diabetic nephropathy and arterionephrosclerosis have become increasingly common. When secondary FSGS develops in these patients, the potential overlap with HIVAN can be diagnostically challenging.
What is the histology of HIV associated nephropathy?
[ 1] HIVAN has a distinct histology, representing a collapsing form of focal segmental glomerulosclerosis (FSGS). The pathogenesis of HIVAN requires local HIV infection of the kidney, with the virus infecting tubular and glomerular epithelial cells.
What kind of nephropathy is found in HIVAN?
Although FSGS is the predominant glomerular lesion in HIVAN, other reported glomerular lesions in patients with HIV include IgA nephropathy, cryoglobulinemia, amyloidosis, and a lupuslike immune complex glomerulopathy. [ 5]
How does HIV 1 affect renal tubular epithelial cells?
In one study, HIV-1 infection was shown to kill renal tubular epithelial cells in vitro by triggering an apoptotic pathway involving caspase activation and Fas up-regulation, suggesting that apoptosis of nonlymphoid cells can be directly induced by HIV-1.