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[Nephrotoxicity of ritonavir]
Presse Medicale (Paris, France : 1983)
|December 16, 1998
Summary
Ritonavir, an HIV antiprotease, can cause severe acute kidney injury. Monitoring renal function is crucial, as this complication can occur with ritonavir alone or combined with saquinavir.
Area of Science:
- Nephrology
- Pharmacology
- Infectious Diseases
Background:
- Ritonavir is an antiprotease medication used for HIV treatment.
- Nephrotoxicity is a recognized, potentially severe side effect of ritonavir therapy.
- Acute renal failure has been observed in patients receiving ritonavir.
Purpose of the Study:
- To investigate the incidence and severity of acute renal failure associated with ritonavir use.
- To assess the impact of ritonavir, alone and in combination with saquinavir, on renal function.
- To highlight the nephrotoxic potential of ritonavir and the need for vigilance.
Main Methods:
- Retrospective analysis of creatinine levels in HIV-positive patients treated with ritonavir.
- Observation of acute renal failure in 8 patients, noting timing and severity.
- Evaluation of renal function in 87 patients treated with ritonavir monotherapy.
Main Results:
- Acute renal failure occurred 3-21 days after ritonavir initiation, often severe with significant creatinine elevation.
- In combination therapy, saquinavir was frequently associated with ritonavir.
- In ritonavir monotherapy, 13.7% of patients (12/87) developed renal failure, with creatinine clearance reduced from 116 to 71 ml/min.
- Ritonavir alone reduced creatinine clearance by 25% in 6 patients within 3 days.
Conclusions:
- Ritonavir possesses a significant nephrotoxic potential, leading to severe acute renal failure.
- This renal complication can manifest with ritonavir monotherapy or in combination regimens, particularly with saquinavir.
- Close monitoring of renal function and control of risk factors are essential for patients on ritonavir treatment.