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Related Experiment Videos

Urolithiasis associated with protease inhibitors.

C P Sundaram1, B Saltzman

  • 1Division of Urology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Journal of Endourology
|July 16, 1999
PubMed
Summary

Urolithiasis is a complication of indinavir sulfate treatment for HIV. Pure indinavir stones are radiolucent on CT scans, while mixed stones may be visible. Conservative management is often effective.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Indinavir sulfate, a protease inhibitor for HIV treatment, can induce urolithiasis.
  • Urolithiasis presents a clinical challenge in HIV-positive patients undergoing treatment.

Purpose of the Study:

  • To evaluate the radiographic characteristics of indinavir-induced urolithiasis.
  • To assess the clinical management strategies for this complication.

Main Methods:

  • Studied 15 consecutive HIV-positive male patients treated with indinavir sulfate.
  • Analyzed radiographic findings (CT imaging) and clinical presentations.
  • Reviewed treatment approaches and stone composition.

Main Results:

  • All patients experienced flank pain; most had hematuria.
  • Indinavir stones were radiolucent on CT unless contrast was used; mixed stones could be radiopaque.
  • Treatment included observation, hydration, ureteral stenting, ureteroscopy, and extracorporeal shockwave lithotripsy.

Conclusions:

  • Urolithiasis is a known complication of indinavir sulfate therapy.
  • Conservative management with hydration is effective for most cases.
  • Metabolic evaluation and correction can prevent future stone formation, allowing continued medication use.

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