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01.05.2012 | Original Article

The spectrum of HIV-related nephropathy in children

verfasst von: Duran Ramsuran, Rajendra Bhimma, Pratistadevi K. Ramdial, Elaene Naicker, Miriam Adhikari, Julian Deonarain, Yetish Sing, Thajasvarie Naicker

Erschienen in: Pediatric Nephrology | Ausgabe 5/2012

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Abstract

Background

Despite the burden of human immunodeficiency virus (HIV) disease in Southern Africa, there have been few reports of HIV-related nephropathy in children. This study outlines the spectrum of HIV-1-related kidney diseases of children in KwaZulu-Natal, South Africa.

Methods

A review of the clinical presentation, laboratory and histopathological findings of children diagnosed with HIV-related nephropathy.

Results

Forty-nine out of 71 children (1–16 years old) with HIV-1 related nephropathy underwent kidney biopsy. The most common histopathological finding was focal segmental glomerulosclerosis (FSGS), which was present in 32 (65.3%) children; 13 (26.5%) having collapsing glomerulopathy and 19 (38.8%) classic FSGS. The majority of patients showed haematological (86.4%) and electrolyte abnormalities (69.4%). Renal impairment was present in 41% of patients on initial presentation. However, end-stage kidney disease was present in only 4% of these patients. All patients were treated with highly active anti-retroviral therapy (HAART), the majority (79.6%) showed decreased proteinuria with 38.8% having complete remission.

Conclusions

This study, one of the largest series of children reported from Africa, demonstrates that nephrotic syndrome due to HIV-associated nephropathy (HIVAN) is the commonest presentation of HIV-related nephropathy in childhood. Highly active anti-retroviral therapy in combination with angiotensin-converting enzyme antagonists is highly effective in decreasing proteinuria and preserving renal function.

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Titel: The spectrum of HIV-related nephropathy in children
verfasst von: Duran Ramsuran
Rajendra Bhimma
Pratistadevi K. Ramdial
Elaene Naicker
Miriam Adhikari
Julian Deonarain
Yetish Sing
Thajasvarie Naicker
Publikationsdatum: 01.05.2012
Verlag: Springer-Verlag
Erschienen in: Pediatric Nephrology / Ausgabe 5/2012
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-011-2074-8

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The spectrum of HIV-related nephropathy in children