Renal disease in children with the acquired immunodeficiency syndrome

Straus, Jacob R.; Abitbol, Carolyn; Zilleruelo, Gastón; Scott, G. W.; Paredes, Ana; S, Málaga; Montané, Brenda; Mitchell, Christopher; Parks, Wade P.; Pardo, Victoriano

doi:10.1016/0020-7292(90)90921-7

Cited by 26 publications

(62 citation statements)

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“…Thus, it is unlikely that tuberculosis contributed to the pathogenesis of their renal disease. The preponderance of male patients (69.4%) in our study was similar to the findings of other studies [2,32,33,39,40]. The reasons for this disproportionate sex incidence to date remains elusive, although genetic factors may play a role.…”

Section: Discussionsupporting

confidence: 92%

The spectrum of HIV-related nephropathy in children

et al. 2011

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Section: Discussionsupporting

confidence: 92%

The spectrum of HIV-related nephropathy in children

et al. 2011

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“…African-Americans constitute the major ethnic group affected [1,2,3,4,5,6,7]. Single-center studies have reported that HIVAN can develop in children.The survival was reported to be poor after onset of clinical renal disease in the pre highly active antiretroviral therapy (HAART) era [8,9,10,11,12,13,14,15,16,17].…”

Section: Introductionmentioning

confidence: 99%

HIV-associated nephropathy and end-stage renal disease in children in the United States

Ahuja

Abbott

Pack

et al. 2004

Pediatric Nephrology

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Single-center studies have reported that HIV-associated nephropathy (HIVAN) can occur in children and may have a clinical course and prognosis similar to that of adults. However, the prevalence and survival has not been reported for a national sample of children with HIVAN and end-stage renal disease (ESRD) on dialysis in the United States. We utilized the United States Renal Data System (USRDS) database to determine the prevalence, demographic information, and survival of children with HIVAN and ESRD in the United States. The Kaplan-Meier method was used to estimate survival of children with HIVAN and the log-rank test was used to compare their survival with children with focal segmental glomerulosclerosis (FSGS) and adults with HIVAN. Cox regression analysis was used to model adjusted hazard ratios (AHR) with HIVAN as a cause of ESRD and its impact on mortality during the study period, adjusted for potential confounders. Of the 7,732 patients identified with HIVAN, only 60 were younger than 21 years and were classified as children; 50% were males and the majority (88.3%) was black. The cumulative percentage survival of children with HIVAN at 12, 24, and 36 months was better than adults with HIVAN (76%, 62%, and 54% vs. 60%, 43%, and 34%). Survival of children with HIVAN who started dialysis after 1996 was significantly better than those who started dialysis in or before 1996 (log rank P value <0.043). However, the major factor associated with better survival on Cox proportional hazard analysis was female gender (male vs. female AHR 2.85, 95% confidence interval 1.04-6.73). We conclude that only a small number of children with HIVAN and ESRD have received dialysis in the United States. The prognosis of these children is better than that of adults with HIVAN and among children with HIVAN females have better survival than males.

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“…Despite commonly reported HIV-nephropathy in infected populations [2,51,60], our children with HIV disease had preserved glomerular function -with a high frequency of isolated hypercalciuria -even when compared to healthy Venezuelan children [32]. Idiopathic Hypercalciuria (IH) is also the most frequent underlying disorder in adults [10] and children who are kidney stone formers [30].…”

Section: Discussionmentioning

confidence: 91%

“…HIVAN was found to occur tenfold more frequently in young African-American males [23], who were mostly affected by focal and segmental glomerulosclerosis (FSGS) [42]. In HIV-infected children, HIVAN is a late event [2], causing nephrotic syndrome [51,60] with FSGS, mesangial hyperplasia, or tubulo-reticular inclusions appearing in renal biopsy [15,60]. There is a distinct trend of increased survival in children with HIV, and, consequently, a greater frequency of kidney disease (>40% in USA), with a larger number of HIV children progressing to ESKD [2].…”

Section: Introductionmentioning

confidence: 99%

Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela

et al. 2007

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Kidney involvement in children with Human Immunodeficiency Virus (HIV) infection is increasing in prevalence in parallel with the longer survival of HIV-infected patients and the side-effects of new antiretroviral drugs. However, there are only a few reports describing renal tubular disorders in HIV+ children. This is a cross-sectional, case series study evaluating kidney disease in 26 Venezuelan HIV-infected children. The study cohort consisted of 15 girls and 11 boys, with a median age of 5.9 years (25-75th percentile: 3.6-7.8), who had been treated with antiretrovirals for 2.8 +/- 0.4 years, Overall, the patients were short for their age and gender (Z-height: -3.1; 25-75th percentile: -4.94 to -1.98), and 15 showed signs of mild to moderate malnutrition. All of the children had a normal estimated glomerular filtration rate (136 +/- 22.6 ml/min/1.73 m2), and glomerular involvement was only observed in one patient with isolated proteinuria. None had nephromegaly. In contrast, tubular disorders were commonly found. Hypercalciuria was detected in 16 of the patients (UCa/Cr = 0.28; 25-75th percentile: 0.17-0.54 mg/mg), with five of these showing crystalluria. Eight children showed hyperchloremia, and three had frank metabolic acidosis. Kidney stones were absent in all, but one boy had bilateral medullary nephrocalcinosis. Conclusion, in Venezuelan children, HIV infection per se, or its specific treatment, was commonly associated with renal tubular dysfunction, especially hypercalciuria and acidosis, potentially leading to nephrocalcinosis and growth impairment. We recommend renal tubular evaluation during the follow-up of children with HIV infection.

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Renal disease in children with the acquired immunodeficiency syndrome

Cited by 26 publications

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The spectrum of HIV-related nephropathy in children

The spectrum of HIV-related nephropathy in children

HIV-associated nephropathy and end-stage renal disease in children in the United States

Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela

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