Perinbasekar S, Brod-Miller C, Mattana J
Absence of edema in HIV-infected patients with ESRD
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:399 1995

Edema was found in only 11 (48.5%) HIV-infected patients developing ESRD, being absent in 13; none of the 13 were receiving diuretics. Significant findings associated with edema included use of antiretroviral drugs, less prior weight loss and less diarrhea. Edematous patients had a higher systolic blood pressure by 35 points , as well as a greater mean and diastolic BP. Mean proteinuria (greater than 8 grams/day) and low serum albumin did not differ between the groups. CD4 counts were significantly higher in patients with edema (283 vs. 62). Using the absence of diarrhea, administration of anti-retrovirals, MAP 95 mmHg and a CD4 > 100 cells/ml, patients with edema could be identified with a sensitivity between 82 and 91%. The effect of variables on Starling forces were proposed as explaining why some patients with HIV-associated nephropathy do not have edema, but the pathophysiology still remains unclear. (Pastan)

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Am Soc Nephrol
Proteinuria/Hematuria : HIV-associated nephropathy