{"id":3626,"date":"2000-06-15T21:51:25","date_gmt":"2000-06-15T20:51:25","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=3626"},"modified":"2014-07-01T12:56:45","modified_gmt":"2014-07-01T12:56:45","slug":"irreversible-renal-dysfunction-linked-to-long-term-indinavir-therapy","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/3626","title":{"rendered":"Irreversible renal dysfunction linked to long-term indinavir therapy"},"content":{"rendered":"<p><strong>A new case report describes a case in which long-term treatment with the protease inhibitor indinavir resulted in renal atrophy with severe secondary hypertension. While indinavir is known to cause nephrolithiasis in a minority of HIV-infected patients, this complication is generally reversible, resolving rapidly with drug discontinuation.<\/strong><\/p>\n<p>The new case report suggests that irreversible renal dysfunction is also a rare, potential complication of indinavir therapy, and that &#8216;clinicians need to be aware of this potential complication,&#8217; according to a report in the March issue of Clinical Infectious Diseases.<\/p>\n<p>Dr Anna Maria Cattelan and colleagues at the General Hospital of Padua in Italy describe their patient as a 39-year-old woman with a 7-year history of HIV infection who began combination antiretroviral therapy with indinavir. Pretreatment ultrasonography revealed &#8216;normal-sized kidneys, with no evidence of renal stones.&#8217;<\/p>\n<p>Nine months after starting therapy, the patient presented with a mild increase in plasma creatinine and hypertension, with arterial blood pressure at 180\/115 mm Hg. She was started on enalapril, which controlled both systolic and diastolic hypertension.<\/p>\n<p>Approximately 6 months later, &#8216;renal ultrasonography revealed right renal atrophy confirmed by both renal scintigraphy and renography,&#8217; Dr Cattelan&#8217;s group reports. Discontinuation of indinavir and replacement with nelfinavir resulted in a significant decrease in the patient&#8217;s blood pressure, however serum creatinine remained &#8216;slightly elevated.&#8217;<\/p>\n<p>This case report &#8216;suggests that renal atrophy may occur during long-term treatment with indinavir without the presence of renal stones or crystalluria,&#8217; the investigators conclude. Although the association between hypertension and indinavir requires additional investigation, the researchers believe that physicians should be aware of this potential complication in HIV-infected patients treated with indinavir.<\/p>\n<h3>Comment<\/h3>\n<p><strong>This is a worrying single case report which should alert physicians to the possibility of these toxicities in other patients<\/strong>.<\/p>\n<p>Reference:<\/p>\n<p>Clin Infect Dis 2000;30:619-621.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A new case report describes a case in which long-term treatment with the protease inhibitor indinavir resulted in renal atrophy with severe secondary hypertension. While indinavir is known to cause nephrolithiasis in a minority of HIV-infected patients, this complication is &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-3626","post","type-post","status-publish","format-standard","hentry","category-side-effects"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/3626","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=3626"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/3626\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=3626"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=3626"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=3626"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}