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Titolo:
Pyuria in patients treated with indinavir is associated with renal dysfunction
Autore:
Sarcletti, M; Petter, A; Romani, N; Lhotta, K; Konig, P; Maier, H; Zangerle, R;
Indirizzi:
Innsbruck Univ, Dept Dermatol & Venerol, HIV Unit, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 Unit, A-6020 Innsbruck, Austria Innsbruck Univ, Dept Internal Med, Div Nephrol, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 phrol, A-6020 Innsbruck, Austria Innsbruck Univ, Inst Pathol, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 athol, A-6020 Innsbruck, Austria
Titolo Testata:
CLINICAL NEPHROLOGY
fascicolo: 4, volume: 54, anno: 2000,
pagine: 261 - 270
SICI:
0301-0430(200010)54:4<261:PIPTWI>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; PROTEASE INHIBITOR INDINAVIR; INTERSTITIAL NEPHRITIS; HIV-INFECTION; UROLITHIASIS; NEPHROLITHIASIS; CRYSTALLURIA; NEPHROPATHY; PHARMACOKINETICS; L-735,524;
Keywords:
indinavir; tubulointerstitial disease; pyuria; renal dysfunction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Zangerle, R Innsbruck Univ, Dept Dermatol & Venerol, HIV Unit, Anichstr 35, A-6020 Innsbruck, Austria Innsbruck Univ Anichstr 35 Innsbruck Austria A-6020 , Austria
Citazione:
M. Sarcletti et al., "Pyuria in patients treated with indinavir is associated with renal dysfunction", CLIN NEPHR, 54(4), 2000, pp. 261-270

Abstract

<(Background)under bar>. Indinavir therapy is associated with a continuum of crystal-related syndromes, including nephrolithiasis, renal colic, flankpain without recognizable stone formation, dysuria and asymptomatic crystalluria. A frank nephropathy has been recognized recently as part of the spectrum. <(Methods)under bar>: A retrospective analysis of 72 HIV-infected individuals receiving indinavir was performed to identify the frequency and risk factors for indinavir-associated nephropathy and urinary complications. Individuals treated with nucleoside analogues alone served as controls. <(Results)under bar>: Mean serum creatinine levels rose from 1.03 +/- 0.16 mg/dl to 1.11 +/- 0.22 mg/dl at week 12 and 1.15 +/- 0.27 mg/dl at week 24 (both, p < 0.01). Thirteen individuals developed serum creatinine levels greater than or equal to 1.4 mg/dl. Increased serum creatinine levels were found more frequently in women (p < 0.01) and were associated with pyuria and microhematuria (p < 0.01). Frank renal colic and/or nephrolithiasis (seven patients) and urinary pH were not associated with serum creatinine levels greater than or equal to 1.4 mg/dl. The mean duration of indinavir treatment,until sterile pyuria occurred, were 22 weeks and 32 weeks until the first rise of serum creatinine levels to greater than or equal to 1.4 mg/dl. Ten patients showed both findings, pyuria preceded the first rise in serum creatinine levels to greater than or equal to 1.4 mg/dl (18 vs. 27 weeks, p = 0.02). Renal biopsy, done in three patients, revealed tubulointerstitial disease with crystals in collecting ducts. In 21 patients, among them 11 with pyuria, indinavir was replaced for various reasons and pyuria disappeared in nine. In these patients mean serum creatinine levels decreased from 1.43 mg/dl at withdrawal of indinavir to 1.04 mg/dl three months later (p < 0.01). <(Conclusion)under bar>: Indinavir therapy is associated with st decrease in renal function which is reversible after withdrawal. In addition, indinavir-associated tubulointerstitial disease does not seem to be a rare complication. Sterile pyuria in patients taking indinavir may help to identify patients being at risk for nephrotoxicity.

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Documento generato il 27/11/20 alle ore 20:50:04