DIAGNOSTIC SONOGRAPHY OF HIV-ASSOCIATED NEPHROPATHY - NEW OBSERVATIONS AND CLINICAL CORRELATION

OBJECTIVE. HIV-associated nephropathy is an important cause of morbidi ty that is characterized clinically by uremia and proteinuria and hist ologically by focal segmental glomerulosclerosis. In the largest serie s yet analyzed to our knowledge, we describe new sonographic findings and record the prevalence of other findings. We review the sonographic findings in a large group of HIV-infected patients. MATERIALS AND MET HODS. Seventy-six consecutive HIV-infected patients underwent renal so nography. Abnormalities seen on sonography were recorded. RESULTS. Of 152 kidneys imaged, sonography showed that 30 kidneys (20%) were enlar ged. Abnormal echogenicity was present in 136 kidneys (89%), Eighty-on e kidneys (53%) were globular; 58 (38%) had decreased corticomedullary definition; 74 (49%) had decreased renal sinus fat; and 66 (43%) had heterogeneous parenchyma, some with echogenic striations. CONCLUSION. Our data reveal several sonographic abnormalities that have not previo usly been described: decreased corticomedullary definition, decreased renal sinus fat, parenchymal heterogeneity, and globular renal configu ration. These new findings were found mainly in patients with advanced HIV infection.