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Clinical and Experimental Nephrology

, Volume 22, Issue 1, pp 68–77 | Cite as

The renal pathological findings in Japanese HIV-infected individuals with CKD: a clinical case series from a single center

  • Masaki HaraEmail author
  • Kumiko Momoki
  • Masamitsu Ubukata
  • Akihito Ohta
  • Akiko Tonooka
  • Minoru Ando
Original article

Abstract

Background

Chronic kidney diseases (CKD) have emerged as a significant cause of morbidity and mortality in patients infected with human immunodeficiency virus (HIV). However, the detailed study of renal pathological findings currently remains unclear in these Japanese patients.

Methods

A retrospective cohort study was undertaken to investigate renal pathological findings between January 1996 and July 2016. Our study included 20 Japanese HIV-infected patients with CKD; 10 cases had undergone renal biopsies, and 10 cases had undergone autopsies, respectively. Moreover, in the 10 biopsied patients, their clinical courses as well as renal outcomes after renal biopsy were also reviewed.

Results

All of the patients had received combination antiretroviral therapy (cART). The 10 biopsy cases (mean age, 54 ± 14 years and duration of cART, 8 ± 5 years) included three cases of diabetic nephropathy (DMN), two of IgA nephropathy, two of cART-induced tubulointerstitial nephritis (TIN), one of minimal change disease, one case of only finding intrarenal arterioles, and one case without abnormal findings. Among those patients, their clinical courses were preferable except for in the DMN cases. In the autopsy cases (mean age, 52 ± 10 years and duration of cART, 5 ± 5 years), no distinct mesangial or membranous abnormalities were detected. Mild to moderate tubulointerstitial atrophies were observed in six cases. Intrarenal arteriosclerosis was identified in nine cases, and the proportion of global glomerulosclerosis seen was 8.4 ± 12.5%/100 glomeruli.

Conclusion

DMN and cART-induced TIN was noted in the biopsy cases. In the autopsy cases, renal arteriosclerosis, global glomerulosclerosis, and tubulointerstitial atrophy were remarkable. Early diagnosis of kidney diseases should be crucial to introduce optimal management, including controlling rigorous comorbidities and appropriate use of cART, to prevent further progression of CKD.

Keywords

Autopsy Chronic kidney disease Combination antiretroviral therapy Human immune deficiency virus Renal biopsy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Informed consent

Informed consent was obtained from all participants prior to enrollment.

Research involving human participants

This study was approved by the Institutional Review Board of Tokyo Metropolitan Komagome Hospital (approval certificate no. 1864) and was conducted in accordance with the Declaration of Helsinki Principles on Human Experimentations.

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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Division of Nephrology, Department of MedicineTokyo Metropolitan Komagome HospitalTokyoJapan
  2. 2.Division of Pathology, Department of MedicineTokyo Metropolitan Komagome HospitalTokyoJapan

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