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[Renal lithiasis due to indinavir].

J M Fernández¹, J E Robles, J M Regojo

¹Departamento Urología, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra.

Revista De Medicina De La Universidad De Navarra

|April 11, 2003

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Indinavir sulphate, an effective HIV protease inhibitor, can cause kidney stones (urolithiasis) due to its poor solubility. Conservative treatment is usually effective for this unique condition.

Area of Science:

Pharmacology
Nephrology
Infectious Diseases

Background:

Indinavir sulphate is a protease inhibitor crucial for managing HIV/AIDS.
It effectively increases CD4+ cell counts and reduces HIV-RNA levels.
However, indinavir use is associated with a significant risk of urolithiasis.

Purpose of the Study:

To describe the characteristics and management of indinavir-induced urolithiasis.
To highlight the diagnostic challenges and treatment strategies for this specific condition.

Main Methods:

Review of clinical data and literature on indinavir urolithiasis.
Analysis of diagnostic imaging limitations and treatment outcomes.

Main Results:

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Indinavir has high urinary excretion and poor solubility, predisposing to stone formation.

Symptoms are typical of urolithiasis, but pure indinavir stones are not visualized by CT.

Conservative management (hydration, pain control, drug cessation) is often successful.

Conclusions:

Indinavir urolithiasis is a distinct clinical entity requiring specific diagnostic and management considerations.
While CT may fail to detect pure indinavir stones, conservative treatment is generally effective.
A minority of patients may require surgical intervention for indinavir-related kidney stones.