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Related Experiment Videos

Protease inhibitor-induced urolithiasis

D L Gentle1, M L Stoller, T W Jarrett

  • 1Department of Urology, University of California School of Medicine, San Francisco 94143-0738, USA.

Urology
|October 24, 1997
PubMed
Summary

Protease inhibitor drugs like indinavir can cause radiolucent urinary stones in HIV/AIDS patients, leading to obstruction. These stones may require intervention and discontinuation of the medication.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Urology

Background:

  • Protease inhibitors are crucial in managing Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS).
  • Indinavir sulfate (Crixivan) is a protease inhibitor used in AIDS treatment.
  • Urinary stone disease is a potential adverse effect associated with indinavir therapy.

Purpose of the Study:

  • To describe the characteristics of urinary stone disease induced by protease inhibitors in HIV/AIDS patients.
  • To analyze the clinical presentation, diagnosis, and management of indinavir-induced nephrolithiasis.

Main Methods:

  • Prospective identification of HIV/AIDS patients experiencing symptomatic renal colic related to indinavir initiation.
  • Retrospective chart reviews and patient interviews were conducted for seven male patients (mean age 42).

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Main Results:

  • Patients developed renal colic after an average of 5.7 months of indinavir therapy.
  • All patients had microscopic hematuria and presented with radiolucent calculi causing moderate- to high-grade obstruction.
  • Stone analysis revealed pure protease inhibitor; six patients discontinued therapy.

Conclusions:

  • Protease inhibitor-induced urinary stones are radiolucent, can cause significant ureteral obstruction, and may not be detected on unenhanced CT scans.
  • Lithotripsy is often ineffective; ureteral stenting can facilitate stone passage.
  • Increased use of protease inhibitors may lead to a rise in symptomatic urinary calculi cases.