indinavir-sulfate and Kidney-Papillary-Necrosis

This case reported to a patient with AIDS who presented persistent sterile leukocyturia and hematuria, lower back pain, bladder suffering symptoms, and renal papillary necrosis which were thought to be secondary to urinary tuberculosis but were demonstrated to be indinavir-associated side effects. The intention of this report is to remind medical professionals involved in the care of HIV+ patients of this possible association in order to avoid unnecessary investigation and to stress the need of careful periodical assessment of renal function and urinalysis in patients treated with indinavir.

Topics: Acquired Immunodeficiency Syndrome; Diagnosis, Differential; Glomerular Filtration Rate; HIV Protease Inhibitors; Humans; Indinavir; Kidney Papillary Necrosis; Male; Middle Aged; Tuberculosis, Urogenital

Papillary necrosis results from ischemia of the renal medulla and papillae, induced by a variety of mechanisms. Papillary necrosis is a rare adverse effect of continuous protease-inhibitor therapy with indinavir.. We describe the case of a patient who developed bilateral papillary necrosis. It was reversible after treatment interruption and increased hydration.. This case shows the need to monitor kidney markers in patients under continuous treatment with indinavir.

Topics: Adult; HIV Protease Inhibitors; Humans; Indinavir; Kidney Papillary Necrosis; Male

The HIV protease inhibitor indinavir may cause nephrolithiasis and interstitial nephritis. The renal consequences of indinavir-associated nephrotoxicity are uncertain. We report a case of papillary necrosis in a patient treated with indinavir. An asymptomatic HIV-infected woman experienced right-sided renal colicky pain during treatment with indinavir. She passed a non-solid stone and continued indinavir treatment. Intravenous pyelogram performed 20 months later following an episode of left-sided colicky pain showed right-sided papillary necrosis. Indinavir-associated nephrolithiasis and chronic interstitial nephritis were the only possible causes identified in this patient. Physicians should be aware that indinavir nephrolithiasis may cause papillary necrosis.

Topics: Adult; Antiretroviral Therapy, Highly Active; Female; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Indinavir; Kidney Papillary Necrosis