Urolithiasis and the protease inhibitor indinavir.

Area of Science:

• Nephrology
• Urology
• Infectious Diseases

Background:

• Protease inhibitors like indinavir are crucial in managing HIV.
• Urological complications associated with indinavir therapy require careful evaluation.

Purpose of the Study:

• To assess the incidence and characteristics of urological abnormalities in patients receiving indinavir.
• To identify risk factors and management strategies for indinavir-induced urolithiasis.

Main Methods:

• A cohort of 155 HIV-positive patients treated with indinavir was monitored.
• Patients experiencing flank pain underwent clinical, laboratory, and imaging examinations.

Main Results:

• Nine percent (14/155) of patients developed severe flank pain, indicative of urolithiasis.
• Diagnostic imaging revealed upper-tract dilatation and obstruction; indinavir crystals were identified in stones.
• Renal insufficiency occurred in some patients, with ureteral stenting required in 4 cases.

Conclusions:

• Indinavir therapy is associated with a 9% risk of urolithiasis.
• Effective management involves hydration, analgesia, and urine acidification.
• Prophylactic measures, including hydration and urine acidification, are vital for preventing complications.