Papillary necrosis associated with the HIV protease inhibitor indinavir.
The HIV protease inhibitor indinavir may cause nephrolithiasis and interstitial nephritis. The renal consequences of indinavir-associated nephrotoxicity are uncertain. We report a case of papillary necrosis in a patient treated with indinavir. An asymptomatic HIV-infected woman experienced right-sided renal colicky pain during treatment with indinavir. She passed a non-solid stone and continued indinavir treatment. Intravenous pyelogram performed 20 months later following an episode of left-sided colicky pain showed right-sided papillary necrosis. Indinavir-associated nephrolithiasis and chronic interstitial nephritis were the only possible causes identified in this patient. Physicians should be aware that indinavir nephrolithiasis may cause papillary necrosis.
Dieleman
J P
JP
Dept. of Internal Medicine II, Erasmus University Medical Center Rotterdam, The Netherlands. dieleman@inw2.azr.nl
van der Feltz
M
M
Bangma
C H
CH
Stricker
B H
BH
van der Ende
M E
ME
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D019469:Indinavir / Q000009:adverse effects* / Q000627:therapeutic use; D007681:Kidney Papillary Necrosis / Q000139:chemically induced* / Q000175:diagnosis
D017320:HIV Protease Inhibitors; D019469:Indinavir