The Utilization of Diagnostic Ultrasound in the Evaluation of the Kidneys in HIV‑Associated Nephropathy
Article Sidebar
Views | PDF/EPUB Downloads:
8
/ 4
/ 1
Main Article Content
Abstract
Aim: To evaluate the renal sizes and echogenicity pattern in patients with human immunodeficiency virus (HIV)‑associated nephropathy and to correlate renal echogenicity with serum creatinine levels and proteinuria.
Materials and Methods: A cross‑sectional study of 100 consecutively confirmed HIV‑seropositive patients aged between 19 and 65 years (Mean ± SD: 35 ± 10.79) comprising 32 males and 68 females with clinical and laboratory features of HIV‑associated nephropathy (HIVAN) was conducted at the Infectious Diseases Clinic of the University of Maiduguri Teaching Hospital, between April 2011 and September 2012. The subjects were evaluated with renal ultrasound scan and the observed abnormalities were recorded. Serum creatinine levels and CD4 + lymphocyte counts were also obtained for all the patients. Proteinuria was established by dipstick method.
Results: Of the 100 cases studied, ultrasound showed enlarged kidneys in 28 patients (28%) and abnormal echogenicity was present in 192 kidneys (96%). 100 kidneys (50%) were globular, 160 kidneys (80%) had decreased corticomedullary definition, 90 kidneys (45%) had decreased renal sinus fat and 80 kidneys (40%) had heterogenous renal parenchymal patterns. A high serum creatinine level, increased degree of proteinuria, lower CD4 counts, reproductive age group and black race were associated with HIVAN.
Conclusion: The severity of HIVAN as indicated by raised serum creatinine level and proteinuria correlated positively with the degree of renal echogenicity.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
How to Cite
References
1. Roling J, Schimid H, Fischeder M, Draenert R, Goebel FD. HIV‑associated renal diseases and highly active antiretroviral
therapy‑induced nephropathy. Clin Infect Dis 2006;42:1488‑95.
2. D’Agati V, Appel GB. Renal pathology of human immunodeficiency virus infection. Semin Nephrol 1998;18:406‑21.
3. Rao TK, Friedman EA. Outcome of severe renal failure in patients with acquired immunodeficiency syndrome. Am J Kidney Dis
1995;25:390‑8.
4. Klotman PE. HIV‑associated nephropathy. Kidney Int 1999;56:1161‑76.
5. Winston JA, Klotman ME, Klotman PE. HIV‑associated nephropathy is a late, not early, manifestation of HIV‑1 infection. Kidney Int
1999;55:1036‑40.
6. Freedman BI, Soucie JM, Stone SM, Pegram S. Familial clustering of end‑stage renal disease in blacks with HIV‑associated nephropathy. Am J Kidney Dis 1999;34:254‑8.
7. Mockrzycki MH, Oo TN, Patel K, Chang CJ. Human Immunodeficiency Virus‑associated nephropathy in the bronx: Low prevalence in a predominantly Hispanic population. Am J Nephrol 1998;18:508‑12.
8. Bourgoignie JJ, Ortiz‑Interian C, Green DF, Roth D. Race, a cofactor in HIV‑1‑associated nephropathy. Transplant Proc 1989; 21: 3899‑901.
9. Di Fiori JL, Rodrigue D, Kaptein EM, Ralls PW. Diagnostic sonography of HIV‑associated nephropathy: New observations and clinical correlations. AJR 1998;171:713‑6.
10. Szczech LA, Gange SJ, van der Horst C, Bartlett JA, Young M, Cohen MH, et al. Predictors of proteinuria and renal failure among
women with HIV infection. Kidney Int 2002;61:195‑202.
11. Hamper UM, Goldblum LE, Hutchins GM, Sheth S, Dahnert WF, Bartlett JG, et al. Renal involvement in AIDS: Sonographic‑pathologic correlation. AJR Am J Roentgenol 1988;150:1321‑5.
12. Schoenfeld P, Feduska NJ. Acquired immunodeficiency syndrome and renal disease: Report of the National Kidney Foundation‑ National Institutes of Health Task Force on AIDS and Kidney Disease. Am J Kidney Dis 1990;16:14‑25.
13. Rao TK, Friedman EA, Nicastri AD. The types of renal disease in acquired immunodeficiency syndrome. N Engl J Med 1987; 316:1062‑8.
14. N’zi PK, Coulibaly A, N’Dri K, Quattara ND, Diabate SA, Zunon‑Kipre E, et al. Ultrasound aspects of abdominal involvement
in adults with HIV infections in the Ivory Coast: A propos of 146 cases. Santé 1999;9:85‑8.
15. Saidu SA, Makusidi MA, Isyaku K, Ma’aji SM. Abdominal ultrasound findings in AIDS patients in Sokoto: A preliminary report. Borno Med J 2005;2:11‑3.
16. Rao TK, Filippone EJ, Nicastri AD, Landesman SH, Frank E, Chen CK, et al. Associated focal and segmental glomerulosclerosis
in the acquired immunodeficiency syndrome. N Engl J Med 1984;310:669‑73.
17. Glassock RJ, Cohen AH, Danovitch G, Parsa P. Human immunodeficiency virus (HIV) infection and the kidney. Ann Intern Med 1990;112:476.
18. Obajimi MO, Atalabi MO, Ogbole GI, Adenke TA, Agunloye AM, Adekanmi AJ, et al. Abdominal ultrasonography in HIV/AIDS
patients in southwestern Nigeria. BMC Med Imaging 2008;8:5.
19. Wachsberg RH, Obolevich AT, Lasker N. Pelvicalyceal thickening in HIV‑Associated Nephropathy. Abdom Imaging 1995;20:371‑5.
20. Chioma PE, Arogundade F, Sanusi A, Adelusola K, Wokoma F, Akinsola A. Renal disease in HIV‑seropositive patients in Nigeria:
An assessment of prevalence, clinical features and risk factors. Nephrol Dial Tranplant 2008;23:741‑6.
21. Atta MG, Longenecker JC, Fine DM, Nagajothi N, Grover DS, Wu J, et al. Sonography as a predictor of human immunodeficiency
virus‑associated nephropathy. J Ultrasound Med 2004;23:603‑10.
22. Burns GC, Paul SK, Toth IR, Sivak SL. Effect of angiotensin‑converting enzyme inhibition in HIV‑associated nephropathy. J Am Soc
Nephrol 1997;8:1140‑6.
23. Atta MG, Choi MJ, Longenecker JC, Haymart M, Wu J, Nagajothi N, et al. Nephrotic range proteinuria and CD4 count as noninvasive indicators of HIV associated nephropathy. Am J Med 2005;118:1288.
24. Brook MG, Miller RF. HIV‑associated nephropathy: A treatable condition. Sex Transm Inf 2001;77:97‑100.