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Table of Contents
Vol. 28, No. 3, 2008
Issue release date: April 2008
Section title: Original Report: Patient-Oriented, Translational Research
Am J Nephrol 2008;28:478–486
(DOI:10.1159/000112851)

Observations on a Cohort of HIV-Infected Patients Undergoing Native Renal Biopsy

Berliner A.R.a · Fine D.M.a · Lucas G.M.b · Rahman M.H.a, d · Racusen L.C.c · Scheel P.J.a · Atta M.G.a
Divisions of aNephrology and bInfectious Diseases and cDepartment of Pathology, Johns Hopkins University School of Medicine, and dDivision of Health Systems, Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Md., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: August 24, 2007
Accepted: November 07, 2007
Published online: January 04, 2008
Issue release date: April 2008

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 6

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN

Abstract

Aims: This study aims to explore the spectrum of renal disease in HIV-infected patients, identify clinical predictors of HIV-associated nephropathy (HIVAN), and investigate the performance of renal biopsy in HIV-infected patients. Method: Of 263 HIV-infected patients with renal disease evaluated between 1995 and 2004, 152 had a renal biopsy, while 111 had not. A group comparison was performed. Results: The leading biopsy diagnoses were HIVAN (35%), noncollapsing focal segmental glomerulosclerosis (22%), and acute interstitial nephritis (7.9%), amongst over a dozen others. There was a trend of decreasing yearly incidence of HIVAN diagnoses, paralleling the use of antiretroviral therapy. By multivariate logistic regression, CD4 counts >200 cells/mm3 and higher estimated glomerular filtration rate were strong negative predictors of HIVAN. HIVAN patients were more likely to require dialysis (p < 0.0001) and had worse overall survival (p = 0.02). Younger age and lower estimated glomerular filtration rate were significant predictors of renal biopsy in multivariate regression analysis. More biopsied patients progressed to dialysis (51 vs. 25%, p = 0.001) and death (15 vs. 5.4%, p = 0.001), despite more frequent corticosteroid treatment (29 vs. 3.6%, p = 0.001). Conclusion: These findings may reflect more severe acute and/or chronic disease at the time of biopsy and suggests that earlier renal biopsy may be warranted in HIV-infected patients, especially in light of the changing spectrum of renal disease in this group.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: August 24, 2007
Accepted: November 07, 2007
Published online: January 04, 2008
Issue release date: April 2008

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 6

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN


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