Journal of Diagnostics Concepts & Practice ›› 2022, Vol. 21 ›› Issue (04): 437-443.doi: 10.16150/j.1671-2870.2022.04.004

• Original articles • Previous Articles     Next Articles

Analysis on the clinicopathological characteristics and follow-up of 32 patients with human immunodeficiency virus infection and chronic kidney diseases

SHI Xia4, MA Xin, WANG Zhenyan, ZHANG Hui2(), LIU Shaojun3   

  1. 1. 1a. Department of Ultrasound Medicine, 1b. Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai 201508, China
    2. Department of Ultrasound, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
    3. Department of Nephrology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
    4. Department of Clinical Medicine, Medical College of Nantong University, Jiangsu Nantong 226019, China
  • Received:2022-09-19 Online:2022-08-25 Published:2022-11-07
  • Contact: ZHANG Hui E-mail:zhang.hui@zs-hospital.sh.cn

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Abstract:

Objective: To analyze the pathological types, clinical characteristics and outcomes of human immunodeficiency virus (HIV)-infected patients with chronic kidney diseases (CKD). Methods: Thirty-two cases of HIV infection combined with CKD who underwent ultrasound guided renal biopsy in Shanghai Public Health Clinical Center from June 2016 to April 2021 were enrolled. Pathological types, clinical conditions and outcomes were all analyzed. Results: Among the 32 patients, there were 28 male and 4 female, with an average age of (43.5±12.3) years. The CD4+T lymphocyte count was (425.9±240.4) cells/μL. Twenty-six patients (81.3%) had been treated with antiretroviral therapy before renal puncture biopsy, and the median treatment time was 24 (1, 72) months. Among the pathological types, membranous nephropathy (8 cases, 25.0%) and IgA nephropathy (6 cases, 18.8%) accounted for the most types, followed by diabetic nephropathy (5 cases, 15.6%). No classical HIV-related nephropathy was found. During the follow-up period of 3 months to 5 years, the remission rate of renal disease reached 84.4% (13 complete remissions, 14 partial remissions), and the unresponsive rate was 9.4% (3 cases, including 1 case of lupus like immune complex mediated proliferative glomerulonephritis, 1 case of diabetes nephropathy, and 1 case of hypertensive nephropathy). The mortality rate was 6.3%(2 cases, all minor lesions). Conclusions: This study shows that the pathological types of HIV infected patients with CKD are various. Membranous nephropathy is predominant pathological type, and followed by IgA nephropathy and diabetes nephropathy, but classical HIV related nephropathy is not common. According to the pathological results of renal biopsy, renal disease related treatment based on antiretroviral therapy can alleviate renal disease or delay the progression of renal disease, but the prognosis of patients with minimal change nephropathy may be poor.

Key words: Human immunodeficiency virus, Nephropathy, Kidney biopsy, Anti-retroviral therapy

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