Nefropatía asociada a virus de inmunodeficiencia humana en un paciente adulto con enfermedad renal crónica terminal

Background: HIV infection remains a problem in developing countries, and it is an infrequent cause of end-stage renal disease. Purpose: to present an uncommon case of end-stage renal disease associated with HIV. Case presentation: A 41-year-old mixed-race male from Cerro de Pasco at 4000 meters above sea level in the highlands of Peru, with a history of hypertension, developed anasarca, bipalpebral edema, and oliguria. During his progression, he presented with azotemia and clinical signs of renal disease, leading to the exclusion of secondary causes. A rapid test for the detection of HIV 1 and 2 antibodies returned reactive, prompting a renal biopsy. The findings included advanced glomerulosclerosis and tubulointerstitial nephritis associated with HIV. The patient began treatment with highly active antiretroviral therapy (HAART) and subsequently underwent peritoneal dialysis, showing improvement and a favorable prognosis. Discussion and conclusion: This case is unusual as HIV-associated nephropathy is almost exclusively observed in black patients and it is currently rare to reach terminal stages. In this patient, nephrotic syndrome and renal failure were the first manifestations of HIV, highlighting the clinical relevance of these renal alterations in the context of the infection. Histopathological findings confirmed the diagnosis and underscore the importance of early detection and timely treatment to prevent progression to end-stage renal failure.