AIDS-RELATED GLOMERULOPATHY - OCCURRENCE IN SPECIFIC RISK GROUPS
AIDS-RELATED GLOMERULOPATHY - OCCURRENCE IN SPECIFIC RISK GROUPS
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DOI：
10.1038/ki.1987.124
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发表时间：
1987-05-01
影响因子：
19.6
通讯作者：
BOURGOIGNIE, JJ
中科院分区：
文献类型：
--
作者：
PARDO, V;MENESES, R;BOURGOIGNIE, JJ
通过肾活检（N = 24）或尸检对159例患者（包括131例成人和28例婴儿和儿童艾滋病患者）的组织病理学和艾滋病相关肾小球病变的发生率进行了评估。35例患者有明显的肾脏疾病临床表现，其特征为肾病综合征伴局灶性节段性肾小球硬化（FSS）。15例患者有弥漫性肾小球系膜增生（MH），无或有轻微的临床肾脏疾病，109例肾小球完整或轻微受累。30名艾滋病静脉注射吸毒者中有15名（50%）有肾脏疾病的证据，而53名同性恋者中只有1名（2%）有临床肾脏疾病，只有6名（11%）有肾小球病理学证据。这项研究证实静脉注射毒品作为肾脏疾病的致病因素的重要风险，并显示在患有艾滋病的同性恋或双性恋男性中肾脏疾病的罕见性。另一方面，30%的海地成年艾滋病患者有弥漫性MH的FSS，尽管静脉注射药物使用在这一人群中不是一个重要的危险因素。此外，28例围产期艾滋病患儿中有8例（29%）有肾脏受累的证据，包括4例肾病综合征和FSS。这些数据为独立于静脉注射药物的艾滋病相关肾小球病的存在提供了强有力的证据，但表明未被识别的辅助因子可能在肾脏疾病的发展中很重要。
The histopathology and incidence of AIDS-related glomerulopathy was evaluated by renal biopsy (N = 24) or at autopsy in 159 patients, including 131 adults and 28 infants and children with AIDS. Thirthy-five patients had overt clinical manifestations of renal disease characterized by a nephrotic syndrome with focal and segmental glomerular sclerosis (FSS). Fifteen patients had diffuse glomerular mesangial hyperplasia (MH) without or with minimal clinical renal disease and 109 had intact or minimally involved glomeruli. Whereas 15 of 30 (50%) i.v. drug users with AIDS had evidence of renal disease, only one of 53 (2%) homosexuals had clinical renal disease and only 6 (11%) had histologic evidence of glomerular pathology. The study confirms the important risk of i.v. drug use as a pathogenic factor of renal disease and shows a rarity of renal disease in homosexual or bisexual men with AIDS. On the other hand, 30% of adult Haitians with AIDS had FSS of diffuse MH, although i.v. drug use is not an important risk factor in this population. Moreover, eight of 28 (29%) children with perinatal AIDS had evidence of renal involvement, including four with a nephrotic syndrome and FSS. The data provide strong evidence for the existence of an AIDS-related glomerulopathy independent of i.v. drug use, but suggest that unrecognized co-factors may be important in the development of renal disease.