Acute renal failure developing during the clinical course of the acquired immunodeficiency syndrome (AIDS) has been related to complications of sepsis, nephrotoxic antibiotics, and recently to the development of glomerular lesions. Of 114 AIDS patients admitted to our hospital between January 1985 and June 1986. II patients (9.6%) developed acute renal failure. None of these II patients had a history of intravenous drug abuse or hypertension. All patients were male with an average age of 35 years old, 81% were black, and all were bisexual or homosexual. Renal failure was attributed to AIDS-related focal glomerulosclerosis (five cases), prerenal azotemia (one case), acute interstitial nephritis (one case), and acute tubular necrosis [four cases). Approximately 15 weeks elapsed from the onset of renal failure to end-stage kidney disease. Only one of five patients survived more than six months after beginning dialysis. Acute renal failure is an important complication of AIDS with glomerular involvement detected in 45% of patients. The long-range problems of initiating and maintaining dialysis therapy in these patients need to be addressed
