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[Anuria in HIV+ patients treated with indinavir]
M J Rebassa Llull1, A Conte Visús, F Grases Freixedas
1Servicio de Urología, Hospital Son Dureta, Palma de Mallorca, España.
Archivos Espanoles De Urologia
|December 29, 2000
Summary
Indinavir can cause severe acute kidney injury in HIV patients due to drug precipitation in urine. Prompt treatment involving fluid administration and urine acidification can resolve this complication.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- HIV infection is often managed with combination antiretroviral therapy.
- Indinavir is a protease inhibitor used in HIV treatment.
Observation:
- Two cases of acute renal failure were observed in HIV-positive patients receiving indinavir.
- Patients presented with oliguria, indicating reduced kidney function.
Findings:
- Indinavir demonstrated a high propensity to precipitate within the renal tubules.
- Crystalluria severity correlated with indinavir dosage and urinary pH.
- This precipitation led to tubulointerstitial nephritis and urinary calculi, causing urinary tract obstruction.
Implications:
- Severe acute kidney injury is a rare but significant complication of indinavir therapy.
- Monitoring renal function and urinary parameters is crucial for patients on indinavir.
- Discontinuation of indinavir, supportive care, and urine acidification are effective management strategies.