Acute renal failure due to bilateral ureteral stone impaction in an HIV-positive patient.
A 51-year-old HIV-positive man treated with atazanavir for 9 months presented with anuria following right flank pain. Laboratory examination indicated renal insufficiency, and abdominopelvic computed tomography scanning showed bilateral hydroureteronephrosis, but no stones were visualized. Endoscopic procedures were performed to investigate the causes of ureteral obstruction and, if possible, to insert Double-J stents in the ureters. A yellowish stone composed of pure atazanavir was found at the right ureteral orifice, and retrograde pyelography revealed a filling defect in the left ureter found to be caused by an atazanavir stone. The patient's renal function recovered after removal of these stones.
Moriyama
Yoji
Y
Department of Urology, Gifu University Hospital, Yanagido 1-1, Gifu, Gifu, 501-1194, Japan. m-yoji@qc5.so-net.ne.jp
Minamidate
Yuzuru
Y
Yasuda
Mitsuru
M
Ehara
Hidetoshi
H
Kikuchi
Mina
M
Tsuchiya
Tomohiro
T
Deguchi
Takashi
T
Tsurumi
Hisashi
H
D058186:Acute Kidney Injury / Q000209:etiology*; D000069446:Atazanavir Sulfate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects / Q000032:analysis*; D011725:Pyridines / Q000009:adverse effects / Q000032:analysis*; D014057:Tomography, X-Ray Computed; D014514:Ureteral Calculi / Q000737:chemistry* / Q000150:complications / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000150:complications
D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate