The New York State Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This course has been awarded 2 contact hours.

A distinct renal syndrome was reported among patients infected with the Human Immunodeficiency Virus (HIV) early in the epidemic by Roa et al. (1984). In the initial study, the focus was on 750 HIV patients treated in two New York City hospitals between 1982 and 1986. Of these patients, it was noted that 78 (10.4%) had been evaluated for renal disease. Twenty-three of the renal patients were eventually diagnosed with a reversible acute renal failure (ARF), while the other 55 had symptoms that included proteinuria, azotemia, or both, and were diagnosed with HIV-Associated nephropathy (HIV-AN). Only two of the patients with HIV-AN survived more than 6 months from diagnosis. In each case the cause of death was listed as “failure to thrive” because patients did not respond positively to nutritional support and/or hemodialysis.

Today, renal insufficiency and chronic renal failure continue to be serious problems in patients with HIV/AIDS. While we have seen some improvement in the number and severity of cases in patients, probably due to successful treatment with antiretroviral medications (ART), there remain multiple causes for concern in this patient population.

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Course Objectives

Upon completion of this course, the learner will be able to

• Review basic renal terminology and physiology.

• Discuss the pathogenesis of HIV associated renal disease.

• Describe symptoms of acute renal disease in HIV positive patients.

• Discuss nursing interventions in acute renal disease in HIV positive patients.

• Describe symptoms of chronic renal disease in HIV positive patients.

• Discuss nursing interventions in chronic renal disease in HIV positive patients.