Background: Human immunodeficiency virus (HIV)-associated nephropathy typically leads to endstage
renal disease requiring dialysis within 3–4 months. This report describes the prenatal course
of 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 of
HIV-associated nephropathy and anemia. She had a CD4 count of 350/mm3, a total urinary protein
of 1.7 g/day, and a serum creatinine of 4.8 mg/dl. The patient was begun on zidovudine, 500
mg daily, and erythropoietin, 4,000 units weekly. At 23 weeks gestation, when she developed
hypertension, a total urinary protein of 3.4 g/day, and a serum creatinine of 4.4 mg/dl, she was
hospitalized. 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 30
weeks gestation, she delivered a viable male infant.Conclusion: HIV-associated nephropathy during pregnancy can be successfully managed with
hemodialysis.
