Key Information
AA-amyloidosis is a systemic disease whose clinical course is characteristically dominated by the renal dysfunction. Patients typically present with nephrotic range proteinuria, nephrotic syndrome and slowly progressive chronic kidney disease (CKD), frequently leading to end-stage kidney disease (ESKD). Left untreated, AA-amyloidosis carries a rather poor prognosis, especially in patients who progress to ESKD. We present a case of HIV related renal AA-amyloidosis in a patient with no other co-morbidities or risk factors, presenting with nephrotic syndrome and rapidly progressive renal dysfunction, becoming dialysis dependent in a matter of 2 weeks. The patient was successfully treated with HAART, allowing him to come off dialysis after 10 months of therapy. In addition, this case highlights the complexity and challenging diagnosis of renal disease in HIV infected patients, with renal biopsy being of utmost importance for accurate diagnosis and management.