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Crystalluria and urinary tract abnormalities associated with indinavir
J B Kopp1, K D Miller, J A Mican
1National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Annals of Internal Medicine
|July 15, 1997
Summary
Indinavir medication can cause unique urinary crystals in HIV patients, potentially leading to kidney stones and urinary symptoms. Monitoring for these crystals is crucial for managing patient health.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Indinavir, a protease inhibitor for HIV, is linked to kidney problems like nephrolithiasis.
- Distinctive urinary crystals and urologic issues have been observed in patients on indinavir therapy.
Purpose of the Study:
- To identify the composition of urinary crystals in patients receiving indinavir.
- To determine the frequency of asymptomatic crystalluria and urinary tract symptoms in this patient group.
Main Methods:
- Analysis of urine specimens from HIV patients undergoing indinavir treatment.
- Utilized microscopic urinalysis, HPLC, and mass spectrometry to characterize urinary crystals and stones.
- Clinical evaluation of patients for urologic symptoms.
Main Results:
- Indinavir crystals were identified in 20% of analyzed urine samples from patients on the drug.
- Compared to controls, indinavir crystals were significantly more prevalent (P < 0.001).
- 8% of patients on indinavir developed urologic symptoms, including nephrolithiasis (3%) and novel syndromes (5%).
Conclusions:
- Indinavir forms characteristic crystals in urine, a condition known as crystalluria.
- This crystalluria can manifest as dysuria, urinary frequency, flank/back pain, and renal colic.
- Intrarenal sludging was observed in some patients experiencing flank or back pain.
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