Human Immunodeficiency Virus-Associated Nephropathy in Pregnancy

[摘要] Background:Human immunodeficiency virus (HIV)-associated nephropathy typically leads to endstagerenal disease requiring dialysis within 3–4 months. This report describes the prenatal courseof a patient with HIV-associated nephropathy requiring dialysis during pregnancy.Case:A 23-year-old nulliparous, black female presented at 13 weeks gestation with a history ofHIV-associated nephropathy and anemia. She had a CD4 count of 350/mm3, a total urinary proteinof 1.7 g/day, and a serum creatinine of 4.8 mg/dl. The patient was begun on zidovudine, 500mg daily, and erythropoietin, 4,000 units weekly. At 23 weeks gestation, when she developedhypertension, a total urinary protein of 3.4 g/day, and a serum creatinine of 4.4 mg/dl, she washospitalized. Her renal function continued to deteriorate, requiring hemodialysis. At 29-4/7 weeks,she developed preterm labor, for which she was placed on indomethacin. Four days later, at 30weeks gestation, she delivered a viable male infant.Conclusion:HIV-associated nephropathy during pregnancy can be successfully managed withhemodialysis.

[学科分类] 妇产科学