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Pyuria in patients treated with indinavir is associated with renal dysfunction
M Sarcletti1, A Petter, N Romani
1Department of Dermatology and Venereology, University of Innsbruck, Austria.
Clinical Nephrology
|November 15, 2000
Summary
Indinavir therapy can cause kidney problems, including decreased kidney function and tubulointerstitial disease. These effects are reversible upon stopping indinavir treatment, and monitoring for urinary changes may help identify at-risk patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Indinavir (IDV) is an antiretroviral protease inhibitor used in HIV treatment.
- IDV therapy is linked to various crystal-related kidney issues, including nephrolithiasis and nephropathy.
- A spectrum of urinary complications and renal dysfunction has been observed with indinavir use.
Purpose of the Study:
- To determine the frequency and risk factors of indinavir-associated nephropathy and urinary complications.
- To analyze renal function changes in HIV-infected individuals receiving indinavir.
- To compare indinavir-treated patients with controls on nucleoside analogues alone.
Main Methods:
- Retrospective analysis of 72 HIV-infected patients on indinavir.
- Comparison with a control group receiving nucleoside analogues.
- Monitoring of serum creatinine, urinalysis (pyuria, microhematuria), and renal biopsy in select cases.
Main Results:
- Mean serum creatinine increased significantly during indinavir therapy (p < 0.01).
- Nephropathy (serum creatinine > or = 1.4 mg/dl) occurred more frequently in women and was associated with pyuria and microhematuria.
- Renal biopsies revealed tubulointerstitial disease with crystals; stopping indinavir reversed renal function decline.
Conclusions:
- Indinavir therapy is associated with reversible decreases in renal function.
- Indinavir-induced tubulointerstitial disease is a recognized complication.
- Monitoring urinary parameters may help identify patients at risk for indinavir nephrotoxicity.