ABSTRACT
As the prevalence of HIV increases, ESRD in patients with HIV will become an increasingly common clinical scenario. Patients with HIV are susceptible to the many causes of ESRD that affect patients without HIV. Furthermore, infection with hepatitis C is more common in patients with HIV, and glomerulonephritis associated with hepatitis C is also more common. There are also causes of ESRD specific to patients with HIV. HIV-associated nephropathy (HIVAN) has become an important cause of renal failure in patients with HIV. HIVAN has become the third leading cause of renal failure in African Americans between the ages of 20 and 64, and is the most common cause of ESRD in patients with HIV (7). The prevalence of HIVAN is probably underestimated. HIVAN is characterized by a collapsing focal and segmental glomerulosclerosis. Diagnosis is confirmed by renal biopsy. The use of HAART may reduce the risk of HIVAN (8), and angiotensin-converting enzyme(ACE) inhibitors and steroids are currently being investigated for the treatment of HIVAN. Unfortunately, a substantial number of these patients ultimately require dialysis.
