HIV associated nephropathy laboratory findings

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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

Laboratory findings in HIV-associated nephropathy include: high-grade proteinuria, elevated serum creatinine levels, hypoalbuniemia, hyperlipidemia, CD4 counts below 200 cells/mm3, hyaline casts, leukocytes, oval fat bodies, and microhematuria.

Laboratory Findings

Renal Biopsy

  • Renal biopsy is the standard in establishing a diagnosis of HIV-associated nephropathy.
  • Renal biopsy reveals focal segmental glomerulonephritis, significant tubulointerstitial injury and microcystic tubular dilation are characteristically seen. [1]
  • Renal biopsy is an essential tool for evaluation and identification of HIV-associated and other kidney diseases in HIV-positive patients, which is important in the management and treatment of the patients.[2]

Other Laboratory Findings

HIV-associated nephropathy (HIVAN) can not be diagnosed clinically or with noninvasive measures such as laboratory findings or ultrasound.

Laboratory findings in HIV-associated nephropathy include:

  • High-grade proteinuria
  • Elevated serum creatinine levels,
  • Hypoalbuniemia
  • Hyperlipidemia
  • CD4 counts below 200 cells/mm3
  • Hyaline casts
  • Leukocytes
  • Oval fat bodies
  • Microhematuria

Routine laboratory tests that may be ordered to help in identify HIV-associated nephropathy (HIVAN) are:

Blood Work-up

  • Complete blood count (CBC)
  • Serum creatinine
  • Lipid profile
  • Albumin
  • ELISA
  • Dot blot
  • Latex agglutination test

Supplemental Test

  • Western blot
  • Immunofluorescence

Urinalysis

  • Proteinuria
  • Microhematuria
  • Leukocytes
  • Oval fat bodies
  • Hyaline casts


References

  1. D'Agati V, Suh JI, Carbone L, Cheng JT, Appel G (1989). "Pathology of HIV-associated nephropathy: a detailed morphologic and comparative study". Kidney Int. 35 (6): 1358–70. PMID 2770114.
  2. Fine DM, Perazella MA, Lucas GM, Atta MG (2008). "Kidney biopsy in HIV: beyond HIV-associated nephropathy". Am J Kidney Dis. 51 (3): 504–14. doi:10.1053/j.ajkd.2007.12.005. PMID 18295067.

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