nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-793Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESРаспространенность и клинико-морфологическая характеристика поражений почек при ВИЧ-инфекцииThe prevalence and clinical-morphological characteristics of renal pathology in HIV infectionГаджикулиеваМ. М.GadzhikulievaM. M.noemail@neicon.ruЮщукН. Д.YuschukN. D.noemail@neicon.ruВолгинаГ. В.VolginaG. V.volginagv@mail.ruСтоляревичЕ. С.StolyarevichE. S.noemail@neicon.ruКуренковаЛ. Г.KurenkovaL. G.noemail@neicon.ruБирюковаЛ. С.BiryukovaL. S.noemail@neicon.ruТомилинаН. А.TomilinaN. A.noemail@neicon.ruГОУ ВПО «Московский государственный медико-стоматологический университет» МинздравсоцразвитияРоссияMoscow State University of Medicine and Dentistry, Russian Federal Health AgencyRussian FederationФГУ «ФНЦ трансплантологии и искусственных органов имени акад. В.И. Шумакова» Минздравсоцразвития РФ, г. Москв; ГОУ ВПО «Московский государственный медико-стоматологический университет» МинздравсоцразвитияРоссияShumakov Federal Research Center of Transplantology and Artificial Organs, MoscowRussian FederationФГУ «ФНЦ трансплантологии и искусственных органов имени акад. В.И. Шумакова» Минздравсоцразвития РФ, г. МосквРоссияShumakov Federal Research Center of Transplantology and Artificial Organs, MoscowRussian Federation2012170620251413140Copyright © Гаджикулиева М.М., Ющук Н.Д., Волгина Г.В., Столяревич Е.С., Куренкова Л.Г., Бирюкова Л.С., Томилина Н.А., 20252025Гаджикулиева М.М., Ющук Н.Д., Волгина Г.В., Столяревич Е.С., Куренкова Л.Г., Бирюкова Л.С., Томилина Н.А.Gadzhikulieva M.M., Yuschuk N.D., Volgina G.V., Stolyarevich E.S., Kurenkova L.G., Biryukova L.S., Tomilina N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/793

Целью настоящего исследования явилось определение частоты, факторов риска повреждения почек и оценка их спектра у пациентов с ВИЧ-инфекцией. Изучена частота поражения почек среди ВИЧ-инфицированных пациентов в рамках анализа эпидемического процесса ВИЧ-инфекции на территории московского мегаполиса. Скрининговые исследования маркеров повреждения почек проведены среди 610 пациентов с ВИЧ-инфекцией, из них 15 пациентам с нефротическим синдромом выполнена биопсия почки. Принимая во внимание постоянный рост показателя пораженности ВИЧ-инфекцией с учетом полученных результатов в скрининговом проспективном эпидемиологическом исследовании, показано увеличение расчетной величины распространенности поражений почек среди ВИЧ-инфицированных. У 24,9% пациентов с ВИЧ-инфекцией выявлен транзиторный характер протеинурии. Персистирующая протеинурия регистрировалась в 10,8% случаев. Нарушение функции почек установлено у 48% пациентов с протеинурией. Показано, что предрасполагающими факторами развития нефропатии могут быть высокая вирусная нагрузка (РНК ВИЧ более 100 000 копий/мл) и депрессия иммунной системы (СD4+-лимфоциты менее 200 клеток/мкл). Морфологическая структура хронических гломерулонефритов у больных ВИЧ-инфекцией с нефротическим синдромом представлена фокально-сегментарным гломерулосклерозом и иммунокомплексным поражением почек. Полученные данные позволяют заключить, что ВИЧ-инфицированные пациенты относятся к группе высокого риска поражения почек и нуждаются в динамическом наблюдении с целью раннего выявления почечной патологии.

The purpose of this study was to determine the frequency and the risk factors of renal failure and to assess their range in patients with HIV infection. The frequency of renal failure among HIV-infected patients in Moscow city was studied. The screening studies of markers of renal failure were performed on 610 patients with HIV infection. Renal biopsy was performed in 15 patients with nephrotic syndrome. Taking into account the steady growth of of HIV infection, the results obtained in screening prospective epidemiological study showed an increase in the calculated value of the prevalence of renal lesions among HIV-infected patients. In 24,9% patients with HIV infection was revealed the transient character of proteinuria. Persistent proteinuria was recorded in 10,8% of cases. Renal impairment was found in 48% of patients with proteinuria. It is shown that the predisposing factors of nephropathy may be a high viral load (HIV RNA of more than 100 000 copies/ml) and depression of immune system (CD4+-lymphocytes less than 200 cells/ml). The morphological structure of chronic glomerulonephritis in HIV-infected patients with nephrotic syndrome is presented with the focal segmental glomerulosclerosis and renal immunocomplex. The data obtained allow us to conclude that HIV-infected patients are at high risk of renal failure and are in need for dynamic monitoring with the purpose of an early detection of renal pathology.

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The authors declare that there are no conflicts of interest present.