Infection with the HIV may lead to a wide spectrum of anatomic and functional derangements in multiple target organs, such as the kidney. HIV associated nephropathy(HIVAN) is the most important cause of chronic renal failure and is seen in those with low CD4 counts. Progression to end stage renal disease is more rapid with most other causes of CRF. HIVAN can have normal kidney sizes or increased kidney size, usually they present withnephroticsyndrome¹.