The spectrum of AKI encountered in patients with HIV.
| Commonly encountered conditions | Examples |
|---|---|
| > Acute tubular injury | > Hypovolaemia, sepsis, nephrotoxic drugs |
| > ‘Acute’ presentations of CKD | > See table 3 |
| Immunodeficiency-associated | |
| > Anti-microbial toxicity | > ATI (eg co-trimoxazole, amphotericin) |
| > TIN (eg co-trimoxazole, rifampicin) | |
| > Crystalluria (aciclovir and sulphadiazine) | |
| > Renal parenchymal infection | > Renal TB |
| > Viral nephropathies (eg CMV, BK – rare) | |
| > Neoplasia | > Infiltration/obstruction eg by lymphoma |
| HIV treatment-associated | |
| > cART nephropathy | > ATI (tenofovir) |
| > Crystalluria/stone obstruction (atazanavir or indinavir) | |
| > TIN (especially atazanavir) | |
| > Immune reconstitution inflammatory syndrome (IRIS) | |
| HIV-virus associated (rare) | |
| > HIVAN | |
| > Immune complex glomerulonephritis | |
| > Thrombotic microangiopathy | |
| > Diffuse infiltrative lymphocytic syndrome | |
| Other conditions | |
| > Rhabdomyloysis | |
| > Recreational drug toxicity | > Cocaine (vasospasm, hypertension, rhabdo) |
| > Ketamine (obstructive uropathy) | |
| > Acute glomerulonephritis | > Bacterial endocarditis |
| > HBV / HCV co-infection | |
| > Post-infectious glomerulonephritis | |
| > Tubulo-interstital nephritis | > Drug induced eg antibiotics, PPIs |
AKI = acute kidney injury; ATI = acute tubular injury; cART = combination anti-retroviral therapy; CMV = cytomegalovirus; HIVAN = HIV-associated nephropathy; PI = protease inhibitor; PPI = proton-pump inhibitor; TIN = tubulo-interstitial nephritis.