Acquired Immunodeficiency Syndrome and Renal Disease: Report of the National Kidney Foundation-National Institutes of Health Task Force on AIDS and Kidney Disease

Abstract

ATIENTS WITH the acquired immunodefi­ ciency syndrome (AIDS) can develop a va­ riety of renal manifestations ranging from mild fluid and electrolyte abnormalities to progressive renal impairment resulting in end-stage renal dis­ ease (ESRD). In 1984, Rao et al initially described the characteristic clinical presentation and course of the most severe form of renal disease in the AIDS patient. 1 Since that time, reports from several centers with large numbers of AIDS pa­ tients have expanded our knowledge of the spec­ trum of renal abnormalities in this patient popula­ tion, but have also raised many puzzling questions regarding the pathophysiology and epidemiology of AIDS-associated renal disease.2·7 This lack of knowledge, in conjunction with the continued growth of the AIDS epidemic, raises concerns in the nephrology community regarding the potential number of AIDS patients with renal disease, par­ ticularly ESRD, that can be expected over the next few years. In addition, the rapid expansion of AIDS knowledge raises new important issues con­ cerning management of patients with human im­ munodeficiency virus (HIV) infection, specific AIDS therapy, and prognosis with renal replace­ ment therapy that must be addressed.