HIV associated nephropathy medical therapy
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HIV associated nephropathy Microchapters |
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Differentiating HIV associated nephropathy from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2];Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]
Overview
Medical Therapy
Corticosteroids
The use of Corticosteroids in the treatment of HIV-associated nephropathy in a retrospective study between 1992 and 1996 has shown that prednisone given at 60mg/d for 2 to 11 weeks was shown to decrease serum creatinine and proteinuria. In other retrospective studies, prednisone given at a dose of 1mg/kg for a span of 2 to 6 weeks has been shown to prolong renal survival before the need of hemodialysis.
ACE Inhibitors
The use of an ACE inhibitor such as Fosinopril has been linked to higher renal survival before progression to end-stage renal disease. The effects where studied in a prospective non-randomized trial between 1993 and 1995. The study showed that the use of an ACE inhibitor decreased the rate patients with HIV-associated nephropathy would develop end-stage renal disease over 5 years. In another retrospective study, the use of captopril with a reverse transcriptase inhibitor prolonged renal survival time by about 156 days as compared to 37 days for those not taking an ACE inhibitor.
HAART
With the advent of HAART therapy the renal survival time in patients with HIV-associated nephropathy has greatly slowed the progression to end-stage renal disease. In a case-control study, the use of antiretroviral therapy for a span of 56 days, has been shown to have a protective effect on the renal. In a another retrospective cohort trial, the use of antiretroviral therapy has showed a survival rate of 18.4 months.[1]
References
- ↑ Atta MG, Gallant JE, Rahman MH, Nagajothi N, Racusen LC, Scheel PJ; et al. (2006). "Antiretroviral therapy in the treatment of HIV-associated nephropathy". Nephrol Dial Transplant. 21 (10): 2809–13. doi:10.1093/ndt/gfl337. PMID 16864598.