Indinavir-associated interstitial nephritis and urothelial inflammation: clinical and cytologic findings.
The objective of the present study was to characterize the genitourinary syndromes that accompany indinavir-associated pyuria. Of 23 indinavir-treated patients with persistent pyuria, 4 had isolated interstitial nephritis, 10 had both interstitial nephritis and urothelial inflammation, 7 had isolated urothelial inflammation, and 2 had pyuria with nonspecific urinary tract inflammation. A total of 21 patients had multinucleated histiocytes identified by cytologic testing of urine specimens. Urine abnormalities resolved in all 20 patients who stopped receiving indinavir therapy. Pyuria continued in the 3 patients who continued receiving indinavir. Six patients had elevated serum creatinine levels, which returned to baseline levels when indinavir was discontinued. In conclusion, indinavir-associated pyuria was frequently associated with evidence of interstitial nephritis and/or urothelial inflammation, multinucleated histiocytes were commonly present in urine specimens, and cessation of indinavir therapy was associated with prompt resolution of urine abnormalities.
Kopp
Jeffrey B
JB
Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, 20892, USA. jbkopp@nih.gov
Falloon
Judith
J
Filie
Armando
A
Abati
Andrea
A
King
Christine
C
Hortin
Glen L
GL
Mican
JoAnn M
JM
Vaughan
Ellen
E
Miller
Kirk D
KD
D000328:Adult; D005260:Female; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D019469:Indinavir / Q000009:adverse effects*; D007249:Inflammation / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D011776:Pyuria / Q000139:chemically induced*; D019459:Urothelium / Q000187:drug effects / Q000473:pathology*
D017320:HIV Protease Inhibitors; D019469:Indinavir