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HIV infection, chronic kidney disease, tubulointerstitial lesions, glomerular kidney lesions

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Moskalyuk, V., Andrushchak, M., Sokolenko, M., Balanyuk , I., & Boyko, Y. (2021). FEATURES OF KIDNEY DAMAGE IN HIV-INFECTED. Medical Science of Ukraine (MSU), 17(1), 29-34. https://doi.org/10.32345/2664-4738.1.2021.04


Relevance. In HIV-infected patients, renal disease, which is characterized by severe clinical manifestations, can significantly affect the prognosis of life. Given the growing number of HIV-infected people in the world and the increase in the life expectancy of such patients, an increase in the number of HIV-infected people in need of expensive renal replacement therapy, as well as kidney transplantation, should be expected. But the question of the nature of kidney damage in HIV infection in Ukraine is still insufficiently covered.

The objective of the work is to establish the clinical and laboratory features of kidney damage in HIV infection.

Materials and methods. 292 patients with HIV were examined. Screening for markers of kidney damage (albuminuria/proteinuria) was performed by test systems (using urine strips). The results obtained with the help of test strips were considered as indicative. In the presence of ≥1+ proteinuria in the screening test, which corresponded to a gradation of 30 mg/l, repeated urine analyzes were performed with quantitative determination of protein on a spectrophotometer, separated in time from 3 days to one week. The functional state of the kidneys was assessed by an integrated indicator that characterizes the degree of preservation/loss of mass of active nephrons. The criterion for renal impairment was a decrease in glomerular filtration rate (GFR) <60 ml/min by 1.73 m2. Chronic kidney disease was diagnosed when proteinuria or proteinuria was detected in combination with a decrease in GFR for 3 months or more.

Results. Based on the main markers of renal damage (persistent proteinuria (PU) and glomerular filtration rate <60 ml/min/1.73m2), 48 people were diagnosed with chronic kidney disease, which was often accompanied by dysfunction of these organs. Based on the analysis of complaints, anamnestic data, and clinical symptoms of kidney damage, patients were divided into 2 groups. The first group (n = 31, or 64.6%) - patients with tubulointerstitial, the second group (n = 17, or 35.4%) - patients with glomerular diseases. Increased PU levels are accompanied by significantly significant renal impairment and a more frequent combination with hypertension and hematuria in the absence of significant differences in the frequency of opportunistic diseases.

Conclusions. In HIV-infected kidney damage is most often characterized by their tubulointerstitial lesions. At the same time, glomerular kidney damage, which is much less common, is accompanied by significantly higher levels of HIV RNA.

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Cohen S.D., Kopp J.B., Kimmel P.L. Kidney diseases associated with human immunodeficiency virus infection. New England Journal of Medicine. 2017; 377(24): 2363-74. DOI: 10.1056/NEJMra1508467

View at: Publisher Site: https://www.nejm.org/doi/10.1056/NEJMra1508467

PubMed: https://pubmed.ncbi.nlm.nih.gov/29236630/

Cristelli M.P., Cofán F., Rico N., Trullàs J.C., Manzardo C., Agüero F., Miro J.M. Estimation of renal function by CKD-EPI versus MDRD in a cohort of HIV-infected patients: a cross-sectional analysis. BMC nephrology. 2017; 18(1): 1-7. doi: 10.1186/s12882-017-0470-4.

View at: Publisher Site: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-017-0470-4

PubMed: https://pubmed.ncbi.nlm.nih.gov/28183270/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301369/

Eisinger R.W., Dieffenbach C.W., Fauci A.S. HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable. Jama. 2019; 321(5): 451-2. doi: 10.1001/jama.2018.21167.

View at: Publisher Site: https://jamanetwork.com/journals/jama/article-abstract/2720997

PubMed: https://pubmed.ncbi.nlm.nih.gov/30629090/

Ellis C.L. HIV associated kidney diseases: Clarifying concordance between renal failure in HIV infection and histopathologic manifestations at kidney biopsy. Seminars in diagnostic pathology. 2017; 34(4): 377-83. doi: 10.1053/j.semdp.2017.04.009

View at: Scopus: https://www.sciencedirect.com/science/article/abs/pii/S0740257017300540?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/28578979/

Europe PMC: https://europepmc.org/article/med/28578979

Frigati L., Mahtab S., Nourse P., Ray P., Perrazzo S., Machemedze T., Zar H. Prevalence of risk factors for chronic kidney disease in South African youth with perinatally acquired HIV. Pediatric Nephrology. 2019; 34(2): 313-8. doi: 10.1007/s00467-018-4080-6.

View at: Scopus: https://link.springer.com/article/10.1007/s00467-018-4080-6

PubMed: https://pubmed.ncbi.nlm.nih.gov/30219929/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529608/

Jotwani V., Atta M.G., Estrella M.M. Kidney disease in HIV: moving beyond HIV-associated nephropathy. Journal of the American Society of Nephrology. 2017; 28(11): 3142-54. doi: 10.1681/ASN.2017040468

View at: Publisher Site: https://jasn.asnjournals.org/content/28/11/3142

PubMed: https://pubmed.ncbi.nlm.nih.gov/28784698/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661296/

Pokrovskiy V.V., Urin О.G., Кravchenko А.V. [National guidelines for dispensary observation and treatment of patients with HIV infection. Clinical Protocol]. Epidemiology and Infectious Diseases. The Actual Issues. 2017; 6(attachment):5-80 [in Russian].

View at: Publisher Site: https://epidemiology-journal.ru/ru/archive/edition/9844

Saag M.S., Benson C.A., Gandhi R.T., Hoy J.F., Landovitz R.J., Mugavero M.J., ... & Volberding P.A. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2018 recommendations of the International Antiviral Society-USA Panel. Jama. 2018; 320(4): 379-96. doi: 10.1001/jama.2018.8431

View at: Publisher Site: https://jamanetwork.com/journals/jama/article-abstract/2688574

PubMed: https://pubmed.ncbi.nlm.nih.gov/30043070/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415748/

Shylov E.M. [Nefrology]. Moscow: GEOTAR-Media, 2010. 696 p. [in Russian].

View at: URL: https://www.rosmedlib.ru/book/ISBN9785970416419.html

Swanepoel C.R., Atta M.G., D’Agati V.D., Estrella M.M., Fogo A.B., Naicker S., Zeier M. Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney international. 2018; 93(3): 545-59. doi: 10.1016/j.kint.2017.11.007

View at: Publisher Site: https://www.kidney-international.org/article/S0085-2538(17)30823-2/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/29398134/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983378/

Wyatt C.M. Kidney disease and HIV infection. Topics in antiviral medicine. 2017; 25(1): 13-6.

View at:PubMed: https://pubmed.ncbi.nlm.nih.gov/28402929/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677039/

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