博士 Sakamoto Emi1,2, Dr Kazuhiro Takeuchi1, Dr Hideaki Kuno1, Dr Minami Suzuki2, Dr Daisuke Katagiri2, Dr Hideki Takano2, Dr Akira Shimizu1
1Nippon Medical School, Bunkyoku Sendagi, Japan, 2Japan Institute for Health Security, National Center for Global Health and Medicine, Shinjukuku, Japan
Biography:
I am a nephrologist and renal pathologist based in Japan, with over 10 years of experience in the field. I work alongside a dedicated team of internal medicine specialists, nephrologists, dialysis experts, and peritoneal dialysis specialists. Currently, I am pursuing graduate studies at Japan Medical University, where I am focused on advancing research in renal pathologies.
Aim:
To investigate the renal pathology in HIV-patients undergoing kidney biopsies in Japan, with a focus on the prevalence and types of renal pathologies associated with HIV.
Background:
The prevalence of HIV is rising globally, and in Japan, this has led to an increase in HIV-related renal diseases. However, cohort studies using kidney biopsies of HIV-patients are limited in Japan. Our institution, a leading center for infectious diseases, conducts a high volume of kidney biopsies and thus undertook this cohort study to further explore renal pathology in HIV-patients.
Methods:
We retrospectively analyzed renal biopsies from 30 HIV-patients who underwent biopsies between 2010 and April 2024. Data collected included age, sex, ethnicity, comorbidities, antiretroviral therapy duration, serum creatinine, proteinuria, and HIV virus loads. Histopathological evaluation was performed using light microscopy, immunofluorescence, and electron microscopy.
Results:
The cohort consisted of twenty-six males, with a median age of 49 years (range: 24–68). Most patients were Japanese (n=27), others are Chinese and Côte d’Ivoire and Ghana. Twenty-two patients had undetectable HIV viral loads. The most common histological diagnoses were atherosclerotic nephrosclerosis and IgA nephropathy (n=7, each), followed by membranous nephropathy and minor glomerular abnormality (n=3, each). Other diagnoses included IgA vasculitis and non-IgA mesangial proliferative nephritis (n=2, each), minimal change nephrotic syndrome, tuberculous granuloma, focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis and HIV-associated nephropathy (HIVAN), HIV-associated immune complex kidney disease (HIVICK) (n=1, each).
Conclusions:
This study represents the largest observational analysis of kidney biopsies in HIV-patients in Japan. Unlike previous reports from other countries, atherosclerotic nephrosclerosis and IgA nephropathy were the most common renal pathologies in this cohort, underscoring the need for further research into HIV-related renal complications in Japan.
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