scholarly journals The significance of antiretroviral-associated acute kidney injury in a cohort of ambulatory human immunodeficiency virus-infected patients

2013 ◽  
Vol 28 (8) ◽  
pp. 2073-2081 ◽  
Author(s):  
Philip Wikman ◽  
Pablo Safont ◽  
María Del Palacio ◽  
Ana Moreno ◽  
Santiago Moreno ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Immunodeficiency Virus

scholarly journals A Rare Cause of Acute Kidney Injury: Primary Renal Lymphoma in a Patient with Human Immunodeficiency Virus

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ruslinda Mustafar ◽  
Lydia Kamaruzaman ◽  
Beh Hui Chien ◽  
Azyani Yahaya ◽  
Noor’Ain Mohd Nasir ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Hematological Malignancy ◽  
Kidney Injury ◽  
B Cell Lymphoma ◽  
Hiv Disease ◽  
Large B Cell Lymphoma ◽  
Renal Lymphoma ◽  
Immunodeficiency Virus ◽  
Combined Antiretroviral Therapy

We reported a case of primary renal lymphoma (PRL) presented with non-oliguric acute kidney injury and bilateral kidney infiltrates in an individual with human immunodeficiency virus (HIV) disease. Acute kidney injury secondary to lymphoma infiltrates is very rare (less than 1% of hematological malignancy). A 37-year-old gentleman with underlying human immunodeficiency virus (HIV) disease was on combined antiretroviral therapy since diagnosis. He presented to our center with uremic symptoms and gross hematuria. Clinically, bilateral kidneys massively enlarged and were ballotable. Blood investigations showed hemoglobin of 3.7 g/L, urea of 65.6 mmol/L, and serum creatinine of 1630 µmol/L with hyperkalemia and metabolic acidosis. An urgent hemodialysis was initiated, and he was dependent on regular hemodialysis subsequently. Computed tomography renal scan showed diffuse nonenhancing hypodense lesion in both renal parenchyma. Diagnosis of diffuse large B cell lymphoma with germinal center type, CD20 positive, and proliferative index 95% was confirmed via renal biopsy, and there was no bone marrow infiltrates. Unfortunately, the patient succumbs prior to initiation of chemotherapy.

scholarly journals Extended Peritoneal Dialysis and Renal Recovery in HIV-Infected Patients with Prolonged AKI: A Report of 2 Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Donlawat Saengpanit ◽  
Pongpratch Puapatanakul ◽  
Piyaporn Towannang ◽  
Talerngsak Kanjanabuch
Keyword(s):  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Stage 4 ◽  
Ckd Stage ◽  
Immunodeficiency Virus ◽  
Small Solute

Peritoneal dialysis (PD) has recently been established as a treatment option for renal replacement therapy (RRT) in patients with acute kidney injury (AKI). Its efficacy in providing fluid and small solute removal has also been demonstrated in clinical trials and is equivalent to hemodialysis (HD). However, effect of RRT modality on renal recovery after AKI remains a controversy. Moreover, the setting of human immunodeficiency virus- (HIV-) infected patients with AKI requiring RRT makes the decision on RRT initiation and modality selection more complicated. The authors report here 2 cases of HIV-infected patients presenting with severe AKI requiring protracted course of acute RRT. PD had been performed uneventfully in both cases for 4–9 months before partial renal recovery occurred. Both patients eventually became dialysis independent but were left in chronic kidney disease (CKD) stage 4. These cases highlight the example of renal recovery even after a prolonged course of dialysis dependence. Thus, PD might be a suitable option for HIV patients with protracted AKI.

scholarly journals Acute Kidney Injury and Urinary Biomarkers in Human Immunodeficiency Virus–Associated Cryptococcal Meningitis

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Charlotte Schutz ◽  
David R. Boulware ◽  
Katherine Huppler-Hullsiek ◽  
Maximilian von Hohenberg ◽  
Joshua Rhein ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Cd4 Count ◽  
Urine Ngal ◽  
Urine Protein ◽  
Immunodeficiency Virus

Abstract Background Cryptococcus is the most common etiology of adult meningitis in Africa. Amphotericin B deoxycholate remains paramount to treatment, despite toxicities, including acute kidney injury (AKI). We assessed the ability of the following urine markers to predict AKI in patients who received amphotericin B: urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), tissue inhibitor of metalloproteinases-2 (TIMP-2), and protein. Methods One hundred and thirty human immunodeficiency virus (HIV)–infected participants with cryptococcal meningitis were enrolled and received amphotericin and fluconazole for 2 weeks. We defined AKI as glomerular filtration rate (GFR) < 60 mL/min/1.73 m2; measured urine NGAL, CysC, TIMP-2, and protein; and explored AKI incidence, risk factors, and associations with mortality using Cox proportional hazards models. Results Participants were 48% female with a median age of 35 years, a median CD4 count of 21 cells/μL, and 44% died within 12 months. Incident AKI occurred in 42% and was associated with mortality (adjusted hazard ratio [aHR] = 2.8; P < .001). Development of AKI was associated with female sex (P = .04) and with higher CD4 count (49 vs 14 cells/μL; P < .01). Urine protein level in the highest quartile independently predicted AKI and mortality (aHR = 1.64, P = .04; aHR = 2.13, P = .02, respectively). Urine NGAL levels in the highest quartile independently predicted AKI (aHR = 1.65; P = .04). Conclusions Acute kidney injury occurred in 42% of patients, and AKI was associated with mortality. Urine biomarkers, specifically urine protein, may be useful for antecedent prediction of amphotericin-associated AKI but need further evaluation.

scholarly journals HIV-related nephropathy: new aspects of an old paradigm

2020 ◽  
Vol 66 (suppl 1) ◽  
pp. s75-s81 ◽  
Author(s):  
Érica Lofrano Reghine ◽  
Renato Demarchi Foresto ◽  
Gianna Mastroianni Kirsztajn
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Chronic Disease ◽  
High Risk ◽  
Infected Patient ◽  
Renal Involvement ◽  
Kidney Injury ◽  
Antiretroviral Drugs ◽  
High Morbidity ◽  
Immunodeficiency Virus

SUMMARY The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretroviral drugs, chronic diseases associated with increased survival, or glomerular disease associated to HIV. This review will cover the main aspects of kidney failure associated with HIV.

scholarly journals Acute Kidney Injury, Immune Thrombocytopenic Purpura, and the Infection That Binds Them Together: Disseminated Histoplasmosis

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774619
Author(s):  
Pooja Sethi ◽  
Jennifer Treece ◽  
Chidinma Onweni ◽  
Vandana Pai ◽  
Sowminya Arikapudi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Immune Thrombocytopenic Purpura ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Kidney Injury ◽  
The United States ◽  
Rare Presentation ◽  
Thrombocytopenic Purpura ◽  
Disseminated Histoplasmosis ◽  
Immunodeficiency Virus

Untreated human immunodeficiency virus (HIV) can be complicated by opportunistic infections, including disseminated histoplasmosis (DH). Although endemic to portions of the United States and usually benign, DH can rarely act as an opportunistic infection in immunocompromised patients presenting with uncommon complications such as acute kidney injury and idiopathic thrombocytopenic purpura. We report a rare presentation of DH presenting with acute kidney injury and immune thrombocytopenic purpura in an immunocompromised patient with HIV.

Abstract 15400: Impact of Human Immunodeficiency Virus Infection on Takotsubo Cardiomyopathy Outcomes in a Large Nationwide Sample

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Laith Ali ◽  
Amre Ghazzal ◽  
Raja Zaghlol ◽  
Sohab Radwan ◽  
Sameer Desale ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Takotsubo Cardiomyopathy ◽  
Statistical Significance ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Inpatient Outcomes ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Classification Of Diseases

Aim: Stress-Induced or Takotsubo Cardiomyopathy (TCM) is characterized by transient wall motion abnormalities often preceded by physical or emotional stress. Various baseline medical comorbidities were associated with worse outcomes theoretically due to their effect on chronic stress exposure. The effect of concurrent Human Immunodeficiency Virus (HIV) infection on outcomes of TCM has not been well established. Methods: We conducted a US-wide analysis of TCM hospitalizations from 2006 to 2014 by querying the National Inpatient Sample (NIS) database for the International Classification of Diseases-ninth Revision (ICD-9) TCM code, baseline characteristics, and inpatient outcomes. TCM patients with HIV were compared to TCM patients without HIV. Multivariate regression models were constructed to account for potential confounders. We identified 123,050 patients hospitalized with TCM, of those patients 304 had positive HIV status. Results: In unadjusted analysis (figure 1), in-hospital outcomes were worse in TCM patients with HIV in terms of development of acute kidney injury (16.8% vs 33.3%, P -value 0.002), use of invasive mechanical ventilation (18.3% vs 34.5%, P -value 0.003), and mortality (5.3% vs 17.1%, P -value <0.0001). After adjusting for age, gender, and comorbidities there was no significant difference in the captured outcomes (table 1). Conclusion: TCM patient with concurrent HIV had numerically worse outcomes. After adjusting for potential confounders, the statistical significance no longer existed, suggesting that statistical difference was primarily driven by difference in baseline sociodemographic parameters and coexisting comorbidities.

Incidence, Etiology, and Outcomes of Community-Acquired Acute kidney injury in Pediatric Admissions in Malawi

2018 ◽  
Vol 38 (6) ◽  
pp. 405-412 ◽  
Author(s):  
Rhys D.R. Evans ◽  
Marie Docherty ◽  
Anna Seeley ◽  
Alison Craik ◽  
Martha Mpugna ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Hospital Mortality ◽  
Prospective Observational Study ◽  
Causes Of Death ◽  
Clinical Presentation ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
The Other ◽  
Immunodeficiency Virus

Background The epidemiology of acute kidney injury (AKI) in children in sub-Sahara Africa (SSA) is poorly described. The aim of this study was to establish the incidence, etiology, and outcomes of community-acquired AKI in pediatric admissions in Southern Malawi. Methods We conducted a prospective observational study of pediatric admissions to a tertiary hospital in Blantyre between 5 February and 30 April 2016. Children were screened for kidney disease on admission with measurement of serum creatinine and assessment of urine output. The clinical presentation, etiology, and management of children with AKI were documented. Results A total of 412 patients (median age 4 years, 52.6% male, and 7.5% human immunodeficiency virus [HIV] infected) were included in the study. Forty-five patients (10.9%) had AKI (Kidney Disease: Improving Global Outcomes [KDIGO] criteria), which was stage 3 in 16 (35.6%) patients. Sepsis and hypoperfusion, most commonly due to malaria ( n = 19; 42.2%), were the causes of AKI in 38 cases (84.4%). Three patients (6.7%) underwent peritoneal dialysis (PD) for AKI: 2 of them recovered kidney function, and the other one died. In-hospital mortality was 20.5% in AKI and 2.9% if no kidney disease was present ( p < 0.0001). Seventeen (47.2%) patients with kidney disease had persistent kidney injury on hospital discharge. Conclusion Acute kidney injury occurs in 10.9% of pediatric admissions in Malawi and is primarily due to infections, particularly malaria. Acute kidney injury results in significantly increased in-hospital mortality. Urgent interventions are required to eliminate preventable causes of death in this region.

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