K UNA many problems that have to face them AIDS patients worldwide. Kidney (kidney) is one of the important organs to filter the toxins in the body.
These patients are most affected by kidney disease. Kidney disease related to Aids professionally HIV-Associated Nephropathy or in brief HIVAN, can be caused by direct HIV-related HIV infection in the kidney or side effects caused by the use of antiretroviral drugs (ARVs).
It is clear that many Aids patients are at risk of developing kidney disease due to dehydration due to frequent vomiting, loss of salt, or poor nutrition.
More than 60% of patients enrolled to start ARVs at the hospital have HIV-related kidney problems which affect women more than men, with low weight and those with CD4 levels below 200.
Researchers have shown a link to the direct HIV-1 attack in the kidney. There is also a strong genetic relationship with environmental sources that stimulate the occurrence of this problem in humans.
HIV-1 attacks more kidney filters (glomeruli) and the walls of its walls than any other part of the kidney.
This condition causes damage to the kidney filters as well as to the tubes and the work of filtration and urinary tract disrupted. As a result the urine has a higher amount of protein than usual, the filter has scars as well as tubulointerstitial scarring.
As well as having all the symptoms of HIVAN patients’ illnesses they also have the following traits / symptoms: The patient’s appearance loses a lot of protein in the urine per day. It also loses a lot of albumin (another very important type of protein).
In addition, with high levels of fat and high protein loss, many HIVAN patients do not have edema.
Has normal blood pressure and abnormal concentration of urea or other nitrogen-producing contaminants in the blood. Kidney appearance in Ultrasound or CT scan consists of kidneys of normal size or very swollen (larger than normal).
Kidney Appearance in a biopsy: The kidneys have scars in their filters that are only visible on a microscope. Also CD4 + T-cell level of patient: Normal CD4 + T cells in patients with HIVAN are below 200 cells / μL.
However, HIVAN can occur even in a patient with a high CD4 count. Patients with CD4 less than 50 cells / μL are more likely to die prematurely from HIVAN.
Measurements and observations
There are many tests such as urinalysis, renal function tests, electrolytes analysis, FBP for detecting blood volume, blood levels and the presence of other diseases that affect the patient.
There is also a Renal Biopsy test; Many doctors prefer to do a biopsy on patients who lose more than 1 gram of protein per day through the urine. There are kidney Ultrasound tests, tubes including the bladder, kidney CT, CD4 count as well as viral load.
HIVAN treatment includes the use of antiretroviral drugs (ARVs) for those who have not yet started the drug, to modify or change the type of ARVs for those who have already started using them to harm the user, and to use other medications as directed by the doctor.