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International Journal of Nephrology
Volume 2014, Article ID 381985, 8 pages
Clinical Study

Impaired Urine Dilution Capability in HIV Stable Patients

1Infectious Diseases Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Peron 4190, 1181 ACH Buenos Aires, Argentina
2Renal Physiology Section, Nephrology Service, Hospital Italiano de Buenos Aires, Peron 4190, 1181 ACH Buenos Aires, Argentina

Received 16 November 2013; Revised 2 February 2014; Accepted 17 February 2014; Published 31 March 2014

Academic Editor: Anil K. Agarwal

Copyright © 2014 Waldo H. Belloso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.