Observations on a cohort of HIV-infected patients undergoing native renal biopsy.

Observations on a cohort of HIV-infected patients undergoing native renal biopsy. Research Abstract Details 

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Observations on a cohort of HIV-infected patients undergoing native renal biopsy. Abstract Text:

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/mm(3) 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.

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Observations on a cohort of HIV-infected patients undergoing native renal biopsy. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: American journal of nephrology

VOLUME: 28

Page Numbers: 478-86

Journal Abbreviation: Am. J. Nephrol.

ISSN: 1421-9670

DAY: 4

MONTH: 01

YEAR: 2008

Observations on a cohort of HIV-infected patients undergoing native renal biopsy. Information

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LANGUAGE: eng

NlmUniqueID: 8109361

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AFFILIATION: Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.

Country: Switzerland

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MEDLINETA: Am J Nephrol

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