Impaired urine dilution capability in HIV stable patients

BELLOSO, WALDO H.; DE PAZ SIERRA, MARIANA; NAVARRO, MATILDE; SANCHEZ, MARISA L.; PERELSZTEIN, ARIEL G.; MUSSO, CARLOS G.

International Journal of Nephrology

Hindawi Publishing Corporation

Año: 2014 vol. 2014

2090-214X

Renal disease is a well-recognized complication among patients with HIV infection. Viral infection itself and the use of some antiretroviral drugs contribute to this condition. The thick ascending limb of Henle´s loop (TALH) is the tubule segment where free water clearance is generated, determining along with glomerular filtration rate the kidney´s ability to dilute urine. Objective. We analyzed the function of the proximal tubule and TALH in patients with HIV infection receiving or not tenofovir-containing antiretroviral treatment in comparison with healthy seronegative controls, by applying a tubular physiological test, hyposaline infusion test (Chaimowitz´ test). Material & Methods. Chaimowitz´ test was performed on 20 HIV positive volunteers who had normal renal functional parameters. The control group included 10 healthy volunteers. Results. After the test, both HIV groups had a significant reduction of serum sodium and osmolarity compared with the control group. Free water clearance was lower and urine osmolarity was higher in both HIV+ groups. Proximal tubular function was normal in both studied groups. Conclusion. The present study documented that proximal tubule sodium reabsorption was preserved while free water clearance and maximal urine dilution capability were reduced in stable HIV patients treated or not with tenofovir. © 2014 Waldo H. Belloso et al.