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HIV and kidney disease

Renal disease and HIV

Perhaps the most renowned renal disease associated with HIV infection is the collapsing variant of FSGS. This typically presents with the nephrotic syndrome and has been associated with relatively advanced HIV infection, with low CD4 counts and higher…

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Nephrotoxic HIV Drugs

I’ve done a post on renal-relevant HIV drugs previously, but I just heard an interesting case of tenofovir-induced renal failure at our Renal Grand Rounds and thought I’d mention a few interesting tidbits from the presentation. 1. HIV-Associated…

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Recent Urine NGAL Biomarkers Studies

Two recent articles in JASN–one by Siew et al and the other by Paragas et al–provide further support to the idea of using urinary NGAL as a biomarker for acute kidney injury. An accompanying editorial by Lynda Szczech,…

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Race & Risk for ESRD

See if you can answer this True or False question:  The increased risk of ESRD in African-Americans is due to the increased risk of hypertension and diabetes seen in this population.   I think the prevailing view in…

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Reticular Inclusions in HIVAN

The histology of HIVAN (HIV-Associated Nephropathy), at the light microscopy level, is indistinguishable from that of collapsing FSGS: the glomerular capillary loops are collapsed. Furthermore, both entities demonstrate foot process effacement (as in all forms of nephrotic syndrome)…

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Differential Diagnosis for Large Kidneys

The differential diagnosis for large kidneys (often demonstrated on renal ultrasound) is interesting, as there are a few conditions which are especially associated with this finding. Of course, with any type of chronic damage, the kidneys tend to…

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Renal Side Effects of HIV Medications

The treatment of HIV infection has been radically changed with the development of HAART–highly active antiretroviral therapy. Fortunately for nephrologists, these medications are relatively safe from a renal standpoint. There are two notable exceptions to be aware of….

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Collapsing Variant of FSGS

The collapsing form of FSGS is a histologic variant which is characterized by mesangial hypercellularity and resultant collapse of the glomerular capillaries, as illustrated in the photo to the left. Its identification is important for prognostic reasons as…

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