Abstract
Background: Human immunodeficiency virus (HIV)-associated nephropathy typically leads to endstage renal disease requiring dialysis within 3–4 months. This report describes the prenatal course of a patient with HIV-associated nephropathy requiring dialysis during pregnancy.
Case: A 23-year-old nulliparous, black female presented at 13 weeks gestation with a history of HIV-associated nephropathy and anemia. She had a CD4 count of 350/mm3, a total urinary protein of 1.7 g/day, and a serum creatinine of 4.8 mg/dl. The patient was begun on zidovudine, 500 mg daily, and erythropoietin, 4,000 units weekly. At 23 weeks gestation, when she developed hypertension, a total urinary protein of 3.4 g/day, and a serum creatinine of 4.4 mg/dl, she was hospitalized. Her renal function continued to deteriorate, requiring hemodialysis. At 29-4/7 weeks, she developed preterm labor, for which she was placed on indomethacin. Four days later, at 30 weeks gestation, she delivered a viable male infant.
Conclusion: HIV-associated nephropathy during pregnancy can be successfully managed with hemodialysis.
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Selected References
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- Bourgoignie J. J. Renal complications of human immunodeficiency virus type 1. Kidney Int. 1990 Jun;37(6):1571–1584. doi: 10.1038/ki.1990.151. [DOI] [PubMed] [Google Scholar]
- Carbone L., D'Agati V., Cheng J. T., Appel G. B. Course and prognosis of human immunodeficiency virus-associated nephropathy. Am J Med. 1989 Oct;87(4):389–395. doi: 10.1016/s0002-9343(89)80819-8. [DOI] [PubMed] [Google Scholar]
- Hou S. H. Frequency and outcome of pregnancy in women on dialysis. Am J Kidney Dis. 1994 Jan;23(1):60–63. doi: 10.1016/s0272-6386(12)80813-4. [DOI] [PubMed] [Google Scholar]
- Hou S., Orlowski J., Pahl M., Ambrose S., Hussey M., Wong D. Pregnancy in women with end-stage renal disease: treatment of anemia and premature labor. Am J Kidney Dis. 1993 Jan;21(1):16–22. doi: 10.1016/s0272-6386(12)80714-1. [DOI] [PubMed] [Google Scholar]
- Michel C., Dosquet P., Ronco P., Mougenot B., Viron B., Mignon F. Nephropathy associated with infection by human immunodeficiency virus: a report on 11 cases including 6 treated with zidovudine. Nephron. 1992;62(4):434–440. doi: 10.1159/000187094. [DOI] [PubMed] [Google Scholar]
- Ortiz C., Meneses R., Jaffe D., Fernandez J. A., Perez G., Bourgoignie J. J. Outcome of patients with human immunodeficiency virus on maintenance hemodialysis. Kidney Int. 1988 Aug;34(2):248–253. doi: 10.1038/ki.1988.172. [DOI] [PubMed] [Google Scholar]
- Rao T. K. A decade of human immunodeficiency virus-associated nephropathy (HIVAN). Transplant Proc. 1993 Aug;25(4):2439–2440. [PubMed] [Google Scholar]