Risk Factors for Urological Symptoms in a Cohort of Users of the HIV Protease Inhibitor Indinavir Sulfate&lt;subtitle&gt;The ATHENA Cohort&lt;/subtitle&gt;

Dieleman, Jeanne P.; Sturkenboom, Miriam; Jambroes, Mariëlle; Gyssens, Inge C.; Weverling, Gerrit-Jan; Veen, J; Schrey, G.; Reiss, Peter; Stricker, Bruno H. Ch.

doi:10.1001/archinte.162.13.1493

Cited by 42 publications

(20 citation statements)

References 28 publications

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“…Of these, seven (3%) had nephrolithiasis and the other 12 (5%) had crystalluria associated with dysuria or with back or flank pain (of 40 patients who were not receiving indinavir, none had similar crystals). In a study of 1219 patients, including 644 individuals treated with indinavir, Dieleman et al [41] estimated at 8.3 per 100 treatment-years the incidence of indinavir-related urologic/nephrologic symptoms (nephrolithiasis, renal colic, flank pain, hematuria, renal failure, or nephropathy) versus 0.8 per 100 treatment-years for other HIV protease inhibitors. The incidence of renal colic was prospectively estimated at 23.6% over 2 years in a cohort of 555 patients treated with a HAART regimen, including indinavir [42].…”

Section: Protease Inhibitorsmentioning

confidence: 99%

HAART-related nephropathies in HIV-infected patients

Daugas¹,

Rougier²,

Hill³

2005

Kidney International

108

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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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Section: Protease Inhibitorsmentioning

confidence: 99%

HAART-related nephropathies in HIV-infected patients

Daugas¹,

Rougier²,

Hill³

2005

Kidney International

108

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“…People with human immunodeficiency virus (HIV) infection have an increased risk for kidney disease for a variety of reasons, including the high prevalence of hepatitis B and C co-infection [1][2][3] , drug abuse 4 , direct effects of HIV on kidney cells [5][6][7][8][9] and nephrotoxicity of several highly active antiretroviral (HAART) medications [10][11][12][13][14] . Kidney disease in HIV infected patients is associated with increased complications and utilization of health care resources [15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Cystatin C and Creatinine in an HIV Cohort: The Nutrition for Healthy Living Study

Jones

Wilson

et al. 2008

American Journal of Kidney Diseases

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“…Previous studies have shown a correlation between IDV nephrotoxicity and low body weight (11,18). This can be attributed * to a reduction in distribution volume, probably leading to higher IDV concentrations in such patients.…”

Section: Discussionmentioning

confidence: 94%

“…The risk factors associated with urological symptoms or renal injury during treatment have been already identified (7,9,11,18). Nevertheless, few clinical studies have been performed to investigate the mechanisms of reduction in renal function in patients receiving longterm treatment with IDV.…”

Section: Discussionmentioning

confidence: 99%

Urinary NO3 excretion and renal failure in indinavir-treated patients

Eira

Araújo

Seguro

2006

Braz J Med Biol Res

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Treatment with indinavir (IDV), a protease inhibitor, is frequently associated with renal abnormalities. We determined the incidence of renal failure (creatinine clearance <80 mL min -1 1.73 (m 2 ) -1 ) in HIV patients treated with highly active antiretroviral therapy, including IDV, and investigated the possible mechanisms and risk factors of IDV nephrotoxicity. Thirty-six patients receiving IDV were followed for 3 years. All were assessed for age, body weight, duration of infection, duration of IDV treatment, sulfur-derivative use, total cholesterol, triglycerides, magnesium, sodium, potassium, creatinine, and urinalysis. We also determined renal function in terms of creatinine clearance, urine osmolality and fractional excretion of sodium, potassium, and water. Urinary nitrate (NO 3 ) excretion was measured in 18 IDV-treated patients and compared with that of 8 patients treated with efavirenz, a drug without renal side effects. Sterile leukocyturia occurred in 80.5% of the IDV-treated patients. Creatinine clearance <80 mL min -1 1.73 (m 2 ) -1 was observed in 22 patients (61%) and was associated with low body weight and the use of sulfur-derivatives. These patients also had lower osmolality, lower urine volume and a higher fractional excretion of water compared to the normal renal function group. Urinary NO 3 excretion was significantly lower in IDV-treated patients (809 ± 181 µM NO 3 -/mg creatinine) than in efavirenz-treated patients (2247 ± 648 µM NO 3 -/mg creatinine, P < 0.01). The lower NO 3 excretion suggests that IDV decreases nitric oxide production.

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Risk Factors for Urological Symptoms in a Cohort of Users of the HIV Protease Inhibitor Indinavir Sulfate<subtitle>The ATHENA Cohort</subtitle>

Abstract: Increased alertness for urological symptoms is warranted for patients starting indinavir treatment, particularly among those with a low lean body mass, during indinavir regimens of 1000 mg or more twice daily, and in warm weather environments.

Cited by 42 publications

References 28 publications

HAART-related nephropathies in HIV-infected patients

HAART-related nephropathies in HIV-infected patients

Cystatin C and Creatinine in an HIV Cohort: The Nutrition for Healthy Living Study

Urinary NO3 excretion and renal failure in indinavir-treated patients

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