indinavir-sulfate and Ureteral-Calculi

We report on 4 cases of urinary stone observed in patients treated with the drug Crixivan (Indinavir Sulfate) and review the literature. Comments include stone composition, clinical aspects, treatment and prevention.

Topics: Adult; Anti-HIV Agents; Calcium Oxalate; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Ureteral Calculi; Ureteroscopy; Urinary Calculi

Topics: Adult; HIV Protease Inhibitors; Humans; Indinavir; Lithiasis; Male; Tomography, X-Ray Computed; Ureteral Calculi; Urologic Surgical Procedures

We report a 27 years old male, treated with Indinavir as a prophylactic anti-HIV agent, who consulted for left ureteral pain. Intravenous and retrograde pyelograms disclosed a radioluscent stone, that was removed surgically. The physical-chemical study of the stone, demonstrated indinavir sulphate crystals.

Topics: Adult; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Radiography; Ureteral Calculi

Topics: Adult; Carcinoma, Transitional Cell; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Ureteral Calculi; Urine; Urologic Neoplasms

Topics: Adult; HIV Protease Inhibitors; Humans; Indinavir; Magnetic Resonance Imaging; Male; Ureteral Calculi; Urography

Topics: Crystallization; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Ureteral Calculi; Ureteral Obstruction

Evaluation of the treatment of complicated ureteric stones in patients treated with indinavir.. From March 1997 to May 1998, 10 patients (7 males, 3 females, aged 30 to 56 years), treated by triple combination therapy for HIV infection, were drained for stones attributed to indinavir (CRIXIVAN), which had become obstructive and complicated. The duration of treatment with indinavir ranged from 14 days to 2 years. No patient had a history of urological disease. One patient presented with bilateral stones. All patients presented complicated clinical features: fever in 3 cases; severe pain in 8 cases, with delayed excretion more than 4 hours on IVU in 6 cases. All stones were radiolucent except for one slightly radioopaque stone. The stone was situated in the lumbar ureter in 3 cases, iliac ureter in 1 case and pelvic ureter in 8 cases.. In 10 out of 11 cases, a double J stent was inserted, preceded by drainage by simple ureteric catheter (infected urine) in 1 case and by percutaneous nephrostomy (PCN) with antegrade insertion of the stent (failure of the retrograde route) in 1 case. No complementary stone fragmentation or extraction treatment was necessary after this procedure. Stents were left in place for 3 to 7 weeks. In one case, a stone of the lumbar ureter required PCN followed by extracorporeal lithotripsy.. In the case of complications requiring a urological procedure, insertion of a double J stent allows curative treatment of very friable indinavir stones, which are fragmented by passage of the stent.

Topics: Adult; Anti-HIV Agents; Colic; Drug Therapy, Combination; Female; HIV Infections; HIV Protease Inhibitors; HIV Seropositivity; Humans; Indinavir; Male; Middle Aged; Stents; Ureteral Calculi; Ureteral Diseases

Indinavir sulfate is a protease inhibitor used in the treatment of the human immunodeficiency virus (HIV). This case report describes the radiographic and urologic manifestations of indinavir urolithiasis in two pediatric patients with acquired immunodeficiency syndrome (AIDS). Management involves aggressive hydration and surgical intervention when indicated.

Topics: Adolescent; Crystallization; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Radiography; Ureteral Calculi; Ureteral Obstruction

We describe the unique CT features of ureteric calculi in six HIV-infected patients receiving indinavir, the most commonly used HIV protease inhibitor, which is associated with an increased incidence of urolithiasis.. Ureteric obstruction caused by precipitated indinavir crystals may be difficult to diagnose with unenhanced CT. The calculi are not opaque, and secondary signs of obstruction may be absent or minimal and should be sought carefully. Images may need to be obtained using i.v. contrast material to enable diagnosis of ureteric stones or obstruction in patients with HIV infection who receive indinavir therapy.

Topics: Adult; Crystallization; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Tomography, X-Ray Computed; Ureteral Calculi; Ureteral Obstruction

Topics: Adult; HIV Protease Inhibitors; HIV Seropositivity; Humans; Indinavir; Male; Ureteral Calculi

The development of HIV protease inhibitors has dramatically improved the treatment prognosis of HIV-infected patients. The treatment, however, is associated with the potential for adverse events that are unique to protease inhibitors. One of them, Indinavir, can lead to the development of urinary stones. Three weeks after starting treatment with Indinavir, Zidovudine and Lamivudine, a 66-year-old patient developed symptomatic hydronephrosis on the right side due to multiple Indinavir stones blocking the ureter. Microhematuria and characteristic crystals were found in the urine. After interruption of treatment and increased fluid intake, the crystallurea was not longer detectable and the patient became asymptomatic within 3 days. Nephrostomy and ureteral stent placement were not necessary. Patients on treatment with Indinavir are required to maintain a fluid intake of at least 1.5-2 l/day to reduce the risk of crystallization and urinary stones. Pharmacologic metaphylaxis to prevent crystallization is not recommended.

Topics: Aged; Anti-HIV Agents; Drug Therapy, Combination; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Lamivudine; Male; Ureteral Calculi; Ureteral Obstruction; Zidovudine