Hypertensive crisis as the first symptom of HIV-associated nephropathy — a case report

Introduction: Despite the observed reduction in the incidence of kidney diseases in patients with human immunodeficiency virus (HIV) infection, kidney injury remains a diagnostic and therapeutic challenge. This case presents a patient with HIV infection and kidney damage, who became a diagnostic and therapeutic challenge. Case report: A 42-year-old female patient of East African origin was admitted to the Infectious Diseases Clinic due to general fatigue, low urine output, generalized edema, and uncontrolled hypertension. She was diagnosed with HIV infection two months before hospitalization, because of fast-progressing anemia and kidney damage with hypertensive crisis (blood pressure values up to 220/120 mmHg) she was sent to the hospital. Due to severe kidney injury, not improving after several hemodialysis procedures, the patient was qualified for chronic hemodialysis (HDs) performed 3 times a week. Nonetheless, by the time of submission of the manuscript HDs were performed without any complications. After repetitive hemodialysis procedures patient’s condition improved, blood pressure was well controlled, anemia and electrolyte disturbances improved, peripheral edemas and total body mass significantly decreased. After broad-spectrum treatment patient was discharged home in good condition. Hypotensive and antiretroviral treatment together with kidney replacement therapy have been continued.