HIV-associated nephropathy (HIVAN)
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Increased bilateral renal parenchymal echogenicity, using the liver as acoustic window, with decreased renal sinus fat. Bilateral kidneys enlarged: right kidney longitudinally measures 144 mm, and the left kidney 123 mm.
46 year old male diagnosed with HIV two years ago, initiated on treatment and subsequently defaulted treatment few weeks later. Now presented with generalized weakness.
On physical examination patient appeared chronically ill: wasted and pale, with generalized edema.
Laboratory results (on presentation):
Urea: 33.8 mmol/L
Creatinine: 637 umol/L
eGFR: 8 mL/min/1.73 m2
Hb: 4.0 g/dL
CD4: 102 cell/uL
HIV viral load: 3,833,345 copies/mL
Laboratory results from a year prior to presentation demonstrated normal kidney functions.
Sent for abdominal ultrasound to rule out acute or chronic kidney injury.