Recent developments in HIV-related kidney disease.
Recent developments in HIV-related kidney disease.
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DOI：
10.2217/hiv.10.42
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Atta MG
中科院分区：
文献类型：
--
作者：
Estrella MM;Fine DM;Atta MG
尽管自艾滋病毒开始流行以来，肾脏疾病一直是公认的艾滋病毒感染并发症，但在HAART已广泛应用的发达国家，其流行病学、根本原因和治疗方法已经发生了变化。HIV相关肾病和HIV免疫复合物介导的肾病是HIV流行早期突出的肾脏诊断。虽然艾滋病毒免疫复合物介导的肾病在艾滋病毒感染的肾病患者中仍然是一种常见的发现，但在发达国家，艾滋病毒相关肾病的发病率一直在下降。长期HAART暴露的代谢效应和某些抗逆转录病毒药物的肾毒性在慢性肾脏疾病的发生和进展中的作用现在越来越受到关注。艾滋病毒感染者急性肾损伤的长期临床意义日益被认识到。艾滋病毒感染者的肾脏疾病仍然是这一患者群体发病和死亡的主要危险因素；因此，早期识别和治疗肾脏疾病对于减轻肾脏疾病对hiv感染者健康的影响至关重要。本文综述了hiv相关肾脏疾病的理解、诊断和管理方面的最新进展和面临的挑战。
Although kidney disease has been a recognized complication of HIV infection since the beginning of the HIV epidemic, its epidemiology, underlying causes and treatment have evolved in developed countries where HAART has been widely available. HIV-associated nephropathy and HIV immune complex-mediated kidney disease were the prominent renal diagnoses in the earlier period of the HIV epidemic. While HIV immune complex-mediated kidney disease remains a common finding among HIV-infected individuals with kidney disease, the incidence of HIV-associated nephropathy has been diminishing in developed countries. The role of the metabolic effects of long-term HAART exposure and nephrotoxicity of certain antiretroviral medications on the development and progression of chronic kidney disease is now of increasing concern. The long-term clinical implications of acute kidney injury among HIV-infected persons are increasingly recognized. Kidney disease in HIV-infected persons continues to be a major risk factor for morbidity and mortality in this patient population; therefore, early recognition and treatment of kidney disease are imperative in lessening the impact of kidney disease on the health of HIV-infected individuals. This review focuses on recent developments and ongoing challenges in the understanding, diagnosis and management of HIV-related kidney disease.