Urolithiasis and the Protease Inhibitor Indinavir

Hermieu, Jean-François; Prévot, Marie-Hélène; Ravery, V.; Sauty, Louis; Moulinier, F; Delmas, V.; Bouvet, E.; Boccon-Gibod, L

doi:10.1159/000019854

Cited by 27 publications

(12 citation statements)

References 6 publications

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“…Between the studies, 350 patients experienced renal colic (13.6%, range 4–28.4%) [ 87 – 93 ]. Three studies analyzed a total of 15 stones for IDV composition, of which three returned with IDV [ 88 , 91 , 92 ]. IDV discontinuation was documented in three studies (n=153, range 7–96) [ 88 , 90 , 91 ].…”

Section: Protease Inhibitors (Pis)mentioning

confidence: 99%

Renal effects of non-tenofovir antiretroviral therapy in patients living with HIV

McLaughlin¹,

Guerrero²,

Merker³

2018

DIC

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A review of literature published regarding non-tenofovir antiretroviral agents causing renal adverse effects was conducted. The literature involving renal adverse effects and antiretroviral therapy is most robust with protease inhibitors, specifically atazanavir and indinavir, and includes reports of crystalluria, leukocyturia, nephritis, nephrolithiasis, nephropathy and urolithiasis. Several case reports describe potential nephropathy (including Fanconi syndrome) secondary to administration of abacavir, didanosine, lamivudine and stavudine. Case reports documented renal events such as acute renal failure, nephritis, proteinuria and renal stones with efavirenz administration. Regarding rilpivirine, a small increase of serum creatinine levels (SCr) was found in clinical trials; however, the clinical significance and impact on actual renal function is unknown. The integrase strand transfer inhibitors and enfuvirtide have a relatively safe renal profile, although studies have shown dolutegravir and raltegravir cause mild elevations in SCr without an impact on actual renal function. This is similar to the reaction observed with cobicistat, the pharmacokinetic enhancer frequently given with elvitegravir.

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Section: Protease Inhibitors (Pis)mentioning

confidence: 99%

Renal effects of non-tenofovir antiretroviral therapy in patients living with HIV

McLaughlin¹,

Guerrero²,

Merker³

2018

DIC

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“…In a prospective study of 54 indinavir-naive HIV-positive individuals by Gagnon et al [37], the prevalence of crystalluria was 67% at the beginning of treatment but decreased to 25% after 2 weeks. The frequency of urinary complications (renal colic, flank pain) has been estimated between 7.4% and 20.8% [28,34,35,[38][39][40]. Kopp et al [28] evaluated the frequency of indinavir-related urinary tract abnormalities.…”

Section: Protease Inhibitorsmentioning

confidence: 99%

HAART-related nephropathies in HIV-infected patients

Daugas¹,

Rougier²,

Hill³

2005

Kidney International

107

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There is no doubt that highly active antiretroviral therapy (HAART) has been the most important progress in the therapy of human immunodeficiency virus (HIV)-infected patients in the last decade. A growing number of observations suggest that the beneficial effects of HAART also include improvement of HIV-related renal complications. Consequently, the cohort of HIV-infected patients requiring HAART has increased and includes patients with preexisting nephropathies, whether related or unrelated to HIV infection. However, some antiretroviral drugs may have renal- and life-threatening side-effects, especially if underlying renal abnormalities exist. In this review, we focus on those aspects that require particular attention in preventing new health complications in HIV-infected patients.

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“…Crystalluria is commonly seen in HIV-infected adults treated with indinavir sulphate, a HIV protease inhibitor [16,63,64]. This drug produces persistent leukocyturia and crystalluria in children and adults [6,15] and characteristically precipitates to form deposits inside the cortical and medullary collecting ducts [26,33], causing nephrolithiasis [16]. Most of our patients were not treated with indinavir.…”

Section: Discussionmentioning

confidence: 97%

Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela

et al. 2007

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Kidney involvement in children with Human Immunodeficiency Virus (HIV) infection is increasing in prevalence in parallel with the longer survival of HIV-infected patients and the side-effects of new antiretroviral drugs. However, there are only a few reports describing renal tubular disorders in HIV+ children. This is a cross-sectional, case series study evaluating kidney disease in 26 Venezuelan HIV-infected children. The study cohort consisted of 15 girls and 11 boys, with a median age of 5.9 years (25-75th percentile: 3.6-7.8), who had been treated with antiretrovirals for 2.8 +/- 0.4 years, Overall, the patients were short for their age and gender (Z-height: -3.1; 25-75th percentile: -4.94 to -1.98), and 15 showed signs of mild to moderate malnutrition. All of the children had a normal estimated glomerular filtration rate (136 +/- 22.6 ml/min/1.73 m2), and glomerular involvement was only observed in one patient with isolated proteinuria. None had nephromegaly. In contrast, tubular disorders were commonly found. Hypercalciuria was detected in 16 of the patients (UCa/Cr = 0.28; 25-75th percentile: 0.17-0.54 mg/mg), with five of these showing crystalluria. Eight children showed hyperchloremia, and three had frank metabolic acidosis. Kidney stones were absent in all, but one boy had bilateral medullary nephrocalcinosis. Conclusion, in Venezuelan children, HIV infection per se, or its specific treatment, was commonly associated with renal tubular dysfunction, especially hypercalciuria and acidosis, potentially leading to nephrocalcinosis and growth impairment. We recommend renal tubular evaluation during the follow-up of children with HIV infection.

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Urolithiasis and the Protease Inhibitor Indinavir

Cited by 27 publications

References 6 publications

Renal effects of non-tenofovir antiretroviral therapy in patients living with HIV

Renal effects of non-tenofovir antiretroviral therapy in patients living with HIV

HAART-related nephropathies in HIV-infected patients

Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela

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