Abstract
Viral infections are important causative agents in renal disease and are responsible for significant morbidity and mortality. Of particular interest are those viral infections with productive replication in the kidney, which often occur in immunocompromized hosts such as renal allograft recipients. Epstein-Barr virus, cytomegalovirus, adenovirus and polyomavirus (type BK) are prominent members of this group causing specific diseases. Other viruses lack direct histological evidence of viral replication in the kidney, such as hepatitis C or human immunodeficiency virus (HIV). They are associated with renal disorders in immunocompetent and/or immunocompromised hosts, and glomerular or tubulo-interstitial 11 injury can be caused via indirect pathways, such as the deposition of immune complexes or cryoglobulins. Glomerular or tubulo-interstitial injury is frequently caused via indirect pathways, such as circulating immune complexes or cryoglobulins. This review will highlight selected viral diseases affecting the kidneys. Emphasis is placed on key morphological criteria, the use of ancillary studies (immunohistochemical staining, electron microscopy) and serologic techniques useful for the histopathologist to establish a step-wise diagnostic approach. The major differential diagnoses entering into the decision-making process are discussed.
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