Kidney function is abnormal in up to 30% of HIV-infected patients.13The most common complication is HIVAN, a disease characterized by massive nephrotic proteinuria (often more than 10 g/day), the absence of edema, and large echogenic kidneys seen on ultrasound. If left untreated, HIVAN can progress to renal failure in 1 to 2 years. HIVAN is almost always seen in patients with advanced immunosuppression (a CD4 cell count under 100).